Dems Exam 2

Front 1

How many grams of carbohydrate should a 70Kg man eat (assume that half of his diet comes from carbs)?

Back 1

262.5g (70kg * 30kcal/kg = 2100 kcal/day * .5 = 1050kcals from carbs/day divided by 4kcal/g (carb energy density) = 262.5g of carbs

Front 2

What category of carbohydrate has greater than 9 monomers?

Back 2

polysaccharides

Front 3

How many monomers are in an oligosaccharide?

Back 3

three to nine

Front 4

Name the sub-classes of (simple) sugars:

Back 4

monosaccharides, disaccharides, polyols

Front 5

An intermediate glycemic index is defined as what range?

Back 5

56-69

Front 6

What is the glycemic load of watermelon? (GI = 72, carbs=5%)

Back 6

3.6

Front 7

Why are whole grains good for you?

Back 7

The husk contains fiber, which promotes good digestion (motility, stool volume) and may lower cholesterol

Front 8

How much fiber should you eat in a day?

Back 8

15-25g

Front 9

What is the difference between soluble and insoluble fiber?

Back 9

soluble absorbs water (and therfore lowers LDL/post-prandial glucose and increases GI bulk better), insoluble does not

Front 10

What are the primary symptoms of lactose intolerance?

Back 10

gas and diarrhea (from fermentation of lactos by coloinic flora/osmotic load to the colon)

Front 11

What health benefits does eating oligosaccharids and amylose provide?

Back 11

incomplete absorption leads to colonic fermentation, which produces short chain fatty acids than help insulin sensitivity and lipid levels

Front 12

Why is amylopectin easier to digest than amylose?

Back 12

Has lots of "free ends" since its highly branched (amylose is linear and has only 2 ends)

Front 13

What is resistant starch?

Back 13

slowly absorbed because of prerparation method - similar health benefits to amylose (ie Corn)

Front 14

What is aspartame?

Back 14

example of "non-nutritive sweetener" - tastes good but unabsorbed

Front 15

What are the THREE types of studies used to inform nutritional decisions?

Back 15

Animal, Epidimelogicial, RCT (small w/soft endpoints, large w/hard endpoints)

Front 16

Which nutritional study type is the "gold standard"

Back 16

large RCT with hard endpoints

Front 17

Explain the difference between glycemic index and glycemic load:

Back 17

Index is the amout of glucose excursion a certain food triggers in a controlled experiment, load is the actual glucose spike produced by the food during normal eating (GI * carb content %)

Front 18

What is the most common acute complication of Diabetes?

Back 18

Hypoglycemia

Front 19

What lab values are necessary to diagnose DKA?

Back 19

Blood glucose > 2oo mg/dl and positive uriny dipstick ketone

Front 20

What are the TWO main components of DKA treatment?

Back 20

Insulin and Fluid Replacement

Front 21

What is the most common cause of DKA?

Back 21

infection (often accompanied by misguided omission of insuilin)

Front 22

At what level do hypoglycemia symtoms appear?

Back 22

Sugar < 50-60 mg/dl

Front 23

What are the TWO hypoglycemia symptom categories?

Back 23

Adrenergic (from excessive Epi secretion) and Neuroglycopenic (from CNS disfunction)

Front 24

Hypoglycemia is more common in which diabetes type?

Back 24

Type 1, since they take insulin more

Front 25

What is the treatment of hypoglycemic unawerness?

Back 25

avoid hypoglycemia for at least 3 weeks

Front 26

What are THREE non-diabetes causes of fasting hypoglycemia?

Back 26

Insulinoma, B cell tumor, MEN 1

Front 27

What is the tell-tale sign of factitious hypoglycemia?

Back 27

High insulin but low C peptide

Front 28

What are the THREE vascular wall responses to diabetes?

Back 28

Abnormal endothelial function, Abnormal smooth muscle fuciton, decreased fibrinolysis

Front 29

Hypertension is more common in which diabetes type?

Back 29

Type 2 (happens in type 1 only after renal disease onset)

Front 30

What are the FOUR main treatments of the macrovascular complications of diabetes?

Back 30

aspirin, B blockers, antihypertensives, lipid lowering agents

Front 31

What are the FOUR mechanisms for MICROvascular complicaitons of diabetes?

Back 31

polyol pathway, non-enzymatic glycosylation, elevation of Protein Kinase C, Osidative/Carbonyl Stress

Front 32

What are the FOUR types of Microvasucular diabetes complications?

Back 32

Retinopathy, Nephropathy, Neuropathy, Foot Disease

Front 33

How do we prevent retinopathy in diabetes?

Back 33

Annual exams (track stages), intervene w/laser during mild/severe PREproliferative stages

Front 34

How is diabetic nephropathy treated?

Back 34

Aggressive control of hyperglycemia and blood pressure (ACE-I and B Blockers)

Front 35

What are the FOUR categories of diabetic neuropathy?

Back 35

Distal symmetric polyneuropathy, Autonomic neuropathy, Mononueritis multiplex, diabetic amyotrophy

Front 36

How can diabetic foot disease be prevented?

Back 36

Appropriate footwear, examination, and education