Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
62 Cards in this Set
- Front
- Back
|
3 types of diabetes:
|
-Diabetes mellitus - I and II
-Diabetes insipidus |
|
|
Acute manifestations of Diabetes mellitus:
|
Polydipsia
Polyuria (sweet pee) Polyphagia Unopposed secretion of GH/EPI |
|
|
What effect does unopposed secretion of GH/Epi have?
|
Makes the hyperglycemia and insulin resistance even worse!
|
|
|
Why is insulin called the anticatabolic hormone?
|
Because it INHIBITS catabolism of Fat/Protein/Glucose.. wants to pack it away in storage for later.
|
|
|
What are 2 acute manifestations more commonly seen in Type I DM?
|
-Weight loss
-DKA |
|
|
What is more common to see in Type II DM?
|
Hyperosmolar coma
|
|
|
What are the 3 effects of insulin deficiency/resistance and Glucagon excess?
|
-Decreased glucose uptake in fat and muscle
-Increased protein CATABOLISM -Increased LIPOLYSIS |
|
|
What are 4 things that lack of glucose uptake by cells results in?
|
-Hyperglycemia (sweet blood)
-Glycsouria (sweet pea) -Osmotic diuresis (polyuria) -Electrolyte depletion |
|
|
What is the result of increased protein catabolism?
|
Increased AA's in the plasma and overexcretion of NITROGEN in URINE
|
|
|
What does the Nitrogen increase in Urine do?
|
Adds to the osmotic diuresis and electrolyte loss
|
|
|
What does Increased lipolysis increase?
|
-Plasma FFA's
-Ketogenesis -Ketonuria -Ketonemia |
|
|
What is the result of all these ketones, Along with the loss of electrolytes and diuresis?
|
DEHYDRATION AND ACIDOSIS
|
|
|
What does untreated dehydration and acidosis lead to?
|
Coma and death.
|
|
|
What are the 2 major CHRONIC manifestations of Diabetes?
|
-Nonenzymatic Glycosylation
-Osmotic damage |
|
|
What does Nonenzymatic glycosylation cause?
|
-small vessel disease
-Large vessel atherosclerosis |
|
|
What IS the small vessel disease caused by nonenzymatic glycosylation?
|
Diffuse thickening of the basement membrane in small vessels!
|
|
|
What are the 3 manifestations of the thick BM in small vessels?
|
-Retinopathy
-Glaucoma -Nephropathy |
|
|
What are 2 results of OSMOTIC damage from the high levels of glucose?
|
-Neuropathy
-Cataracts |
|
|
What is Type I DM caused by?
|
Destruction of B-cells
|
|
|
What is Type II DM caused by?
|
Insulin resistance followed by insulin deficiency
|
|
|
What type requires insulin treatment always?
|
Type I
|
|
|
Which type of DM has a stronger genetic predisposition?
|
Type II
|
|
|
Which type of DM is associated with an HLA system?
|
Type I
|
|
|
Which HLA system?
|
HLA-DR3 and DR4
|
|
|
In which type is glucose intolerance severe? Mild-mod?
|
Severe - type I
Mild-mod - Type II |
|
|
In which is Ketoacidosis more common?
|
Type I
|
|
|
What is one of the most IMPORTANT COMPLICATIONS of Type I DM?
|
Ketoacidosis!
|
|
|
What is Ketoacidosis caused by?
|
An increase in insulin requirements from an increase in STRESS (infection)
|
|
|
What happens in Ketoacidosis?
|
Fat breakdown occurs in excess, and the increased FFA's undergo ketogenesis and make ketones.
|
|
|
CLASSIC signs/sx of Ketoacidosis:
|
-Kussmaul respirations
-Hyperthermia/Dehydration -N/v/abdominal pain -Psychosis/dementia -Fruity ketone breath |
|
|
What are Kussmaul respirations?
|
Rapid, deep breathing
|
|
|
6 Lab Findings in KETOACIDOSIS:
|
-Hyperglycemia
-Metabolic acidosis w/ anion gap -Hypo Bicarb -Increased Blood Ketones -Increased WBCS - leukocytosis -HyperKALEMIA |
|
|
Why is there a hyperkalemia in diabetic ketoacidosis?
|
The ACIDOSIS displaces K from inside cells
|
|
|
What are 5 complications of Diabetic Ketoacidosis?
|
-Life threatening mucormycosis
-Rhizopus infection -Cerebral edema -Cardiac arrythmias -Heart failure |
|
|
How do you TREAT diabetic ketoacidosis?
|
-Replace fluids
-Give Insulin -Give Potassium -Give glucose if needed to prevent hypoglycemia |
|
|
Why do you need to give Potassium?
|
They're hyperkalemic but intracellular K is depleted
|
|
|
Diabetes insipidus is:
|
inability to concentrate urine due to lack of ADH
|
|
|
Symptoms of DI:
|
-Polyruria (dilute urine)
-Polydipsia |
|
|
What are 3 drugs that can cause nephrogenic DI?
|
-Hypercalcemia
-Lithium -Demeclocycline |
|
|
How do you diagnose Diab insipidus:
|
Water deprivation test - fails to concentrate urine
|
|
|
What are 2 lab findings in DI:
|
-Urine sp grav <1.006
-Serum Osm is >290 |
|
|
Treatment for all DI:
|
Adequete fluid intake
|
|
|
Treatment for Central DI:
|
Intranasal Desmopressin
|
|
|
Treatment for Nephrogenic DI:
|
-HCTZ
-Indomethacin -Amiloride |
|
|
4 causes of siADH:
|
-Ectopic ADH (small cell lung cancer)
-CNS disorders/head trauma -Pulmonary disease -Drugs |
|
|
What's a drug that can cause siADH?
|
Cyclophosphamide
|
|
|
3 lab findings in siADH:
|
-Excess Water RETENTION
-HYPOnatremia -Urine osm > Serum osm! (opposite of DI) |
|
|
Treatment for siADH:
|
-Demeclocycline
-Water restriction |
|
|
What can very low serum sodium levels LEAD to?
|
Seizures
|
|
|
How should you go about treating siADH?
|
Correct sodium levels VERY SLOOOOWLLLY
|
|
|
What is Carcinoid syndrome?
|
A rare syndrome caused by carcinoid tumors
|
|
|
What are carcinoid tumors derived from?
|
Neuroendocrine cells of the GI tract
|
|
|
What do Carcinoid tumors secrete?
|
High levels of SEROTONIN
|
|
|
How bad will carcinoid syndrome be if the tumors remain confined to the GI Tract?
|
NOT BAD - serotonin undergoes high FPE!
|
|
|
What are the 4 manifestations of carcinoid syndrome?
|
CARD
-Cutaneous FLUSHING -ASTHMATIc WHEEZING -Right sided VALVE disease -DIARRHEA |
|
|
What is Carcinoid syndrome treated with?
|
Octreotide
|
|
|
What is the rule of 1/3's?
|
1/3 metastasize
1/3 present with a 2nd malignancy 1/3 multiples |
|
|
What is Carcinoid tumor the most common tumor OF?
|
The appendix!
|
|
|
What is a lab finding in Carcinoid syndrome?
|
Elevated urine 5-HIAA (from serotonin)
|
|
|
What is Zollinger-Ellison again?
|
Gastrin-secreting tumor in the pancreas or duodenum
|
|
|
What does ZE syndrome cause?
|
Recurrent ulcers
|
|
|
What syndrome may be associated with ZE?
|
MEN I (PAN)
|
