Pbd Section 2 For Final Exam

Front 1

On average how many times do diabetic patients see their pharmacist each month?

Back 1

4

Front 2

What is the most common endocrine disease?

Back 2

Diabetes Mellitus

Front 3

How many people in the US are effected by Diabetes? How many are unaware of it?

Back 3

23 million

25%

Front 4

T/F 1 in 3 Americans born in 2000 will develop diabetes.

Back 4

True

Front 5

How many years does Diabetes take off of your life on average?

Back 5

10-15 years

Front 6

T/F The US has the highest incidence of Diabetes in the world.

Back 6

False, India does

Front 7

How many new cases of Diabetes are there per year?

Back 7

1.5 million

Front 8

__% of all diabetic deaths are ____ related.

Back 8

75% are CV related

Front 9

Choose One
Diabetes can be defined as a genetically determined disorder of metabolism of heterogeneous/homogeneous etiology.

Back 9

heterogeneous

Front 10

Match
Type 1 Diabetes
Type 2 Diabetes

Abolute
Relative

Back 10

Type 1 - Absolute
Type 2 - Relative

Front 11

Glycosuria causes one tell-tale signs/symptoms?

Back 11

Polydypsia
Polyphagia
Polyuria

Front 12

Diabetes tends to cause an acceleration in _________.

Back 12

Atherosclerosis

Front 13

Give the following numerical values for what would be a diagnostic criteria for diabetes:
FPG?
2 hr OGTT?

Back 13

>= 126 mg%

>= 200 mg%

Front 14

T/F Adults over 45 should have their blood glucose tested every 3 years?

Back 14

True

Front 15

T/F Adults over 45 in high risk groups should have their blood glucose tested every 3 years?

Back 15

False - every year in high risk group

Front 16

What are the classical triad of symptoms in Diabetes?

Back 16

Polydypsia
Polyphagia
Polyuria

Front 17

What is the reason that it is recommended that diabetics get a urinalysis annually? What are they checking for?

Back 17

Checking for microabuminuria because this gives an indication of renal and CV risks.

Front 18

What has higher levels of glucose: plasma or whole blood? How much more?

Back 18

Plasma has 10%-15% more glucose

Front 19

T/F Type 1 Diabetes although not the major diabetic disease state still represents 25% of all diabetic patients.

Back 19

False - Type 1 only represents 5-10%

Front 20

Answer the following related to Type 1 Diabetes compared to Type 2:
Speed of Onset?
Age of Onset?
Weight/Body Type?
Family history?

Back 20

Speed of onset - dramatic
Age of onset - <40 years old
Weight/Body Type - Normal to Slim
Family history - less common than Type 2

Front 21

Autoimmune components of Diabetes could be caused by ____ genes on chromosome __.

Back 21

HLA Genes

Chromosome 6

Front 22

What do HLA genes code for?

Back 22

Which surface antigens are produced

Front 23

Which HLA genes are correlated with Type 1 Diabetes? Which are weakly protective? Strongly protective?

Back 23

Correlated - DR3 and DR4

Weakly Protective - DR5

Strongly Protective - DR2, 11, 15

Front 24

T/F People with both the DR3 and DR4 HLA genes are more at risk to develop Type 1 Diabetes than someone with just one of them.

Back 24

True 20-40x vs. 8x risk

Front 25

T/F Islet cell autoantibodies are found in all Type 1 diabetics.

Back 25

False, only found in 70-85%

Front 26

Type 1 diabetics show an abnormally high level of ______. (not glucose although this is correct)

Back 26

Glucagon

Front 27

Type 1 diabetics show an increase in what group of hormones?

Back 27

Counter-regulatory

Front 28

Without insulin therapy Type 1 diabetics would get both hyperglycemia and _________.

Back 28

Ketoacidosis

Front 29

Approximately what percentage of Americans are clinically obese?

Back 29

30%

Front 30

T/F The major complication in Type 2 Diabetes is macrovascular.

Back 30

True

Front 31

What are the two major risk factors for developing Type 2 Diabetes?

Back 31

Obesity and Age

Front 32

Levels of what cytokine are elevated in obese that could possibly explain progression to Type 2 Diabetes?

Back 32

TNF-alpha

Front 33

In Type 2 Diabetes there is a decrease in this receptor ______, which leads to beta cell _________.

Back 33

GLUT 2
Desensitization

Front 34

In Type 2 diabetics there is an increase in the synthesis of _______.

Back 34

Glucagon

Front 35

In Type 2 Diabetes what organ mainly fails to respond normally to insulin? This leads to a deficiency of what?

Back 35

Liver

Glycogen synthesis

Front 36

Impaired glucose tolerance is called what?

Back 36

Insulin Resistance

Front 37

What 3 things lead to increased glucose production in Type 2 Diabetics?

Back 37

1. Increased glucagon synthesis
2. Increased FFA mobilization
3. Decreased glucose utilization (no insulin, therefore no way to inhibit glycogenolysis/gluconeogenesis)

Front 38

What hormone is diminished in Type 2 Diabetics that is responsible for 50% of postprandial insulin release in healthy patients?

Back 38

Incretin GLP-1

Front 39

T/F GTT are now routine for all pregnancies at 24-28th week of gestation.

Back 39

False, they are no longer routinely checked

Front 40

What demographic is routinely checked for a diabetic condition during pregnancy? What week of pregnancy (range)?

Back 40

>25 yoa OR in high risk group

24-28th week of gestation

Front 41

What are the two conditions seen in infants when the mother was hyperglycemic during pregnancy?

Back 41

1) Infant Respiratory Distress Syndrome - Hyperglycemia/insulinemia cause decreased levels of surfactant

2) Macrosomnia - >9 lbs at birth

Front 42

How does an infant at birth suddenly develop hypoglycemia when born from a hyperglycemic mother?

Back 42

Insulin doesn't cross placental membrane but glucose does. At birth fetus is producing its own insulin which rapidly decreases hyperglycemic condition from mother but is not producing its own glucose so a hyperinsulinemic and subsequent hypoglycemic state arises.

Front 43

T/F First generation oral hypoglycemic agents can be used during pregnancy.

Back 43

False, they are contraindicated because they can cross the placental membrane.

Front 44

Gestational Diabetes mothers have a ___% chance of developing Type 2 Diabetes within 5-10 years.

Back 44

20-50%

Front 45

T/F Infants born from Gestational Diabetic mothers have a higher risk of developing Type 2 Diabetes later in life AND the daughters are at a higher risk for developing DB during pregnancy.

Back 45

Both are true

Front 46

Impaired Glucose Tolerance (IGT) is now commonly referred to as what? What FPG puts you under this category?

Back 46

Pre-Diabetes

>100mg% but <126 mg%

Front 47

__% of pre-Diabetics develop Type 2 within a year and __% chance for Type 2 in 30 years.

Back 47

10%

75%

Front 48

What are the ABC's of Diabetes?

Back 48

Hb A1C
Blood Pressure
Cholesterol

Front 49

What is the HbA1C target for diabetics?

Back 49

<7%

Front 50

What is the blood pressure target for diabetics?

Back 50

<130/80 mmHg

Front 51

How often should diabetics have A1C checked? Cholesterol?

Back 51

A1C - 2x per year

Cholesterol - annually

Front 52

What is the target cholesterol levels for diabetics? Triglycerides?

Back 52

HDL > 50 mg% women HDL > 40 men
LDL < 100 mg%
Triglycerides < 150mg%

Front 53

For every 1% of HbA1C how many mg% is glucose elevated? Over what time period?

Back 53

29 mg%

60 day average