Term
| What lab levels can be drawn to rule out pheochromacytoma? |
|
Definition
| catecholamine levels (epi, norepi & dopamine). |
|
|
Term
| By what age is type I DM usually diagnosed & what age does diagnosis usually peak at? |
|
Definition
| by 30 years of age with a peak at 12-14 years of age. |
|
|
Term
| What casual BS level is indicative of DM? |
|
Definition
|
|
Term
| What FSBS (no caloric intake X previous 8 hours) is indicative of diabetes? |
|
Definition
|
|
Term
| What serum BS level, after glucose tolerance test, is indicative of DM (bonus question - how many carbs should be used in GTT?)? |
|
Definition
| >/= 200; 75gms of glucose. |
|
|
Term
| What serum BS level indicates impaired glucose tolerance after GTT? |
|
Definition
|
|
Term
| According to the ADA, what A1C level is an appropriate goal for DM patients? |
|
Definition
|
|
Term
| According to the ADA, what preprandial glucose level is an appropriate goal for DM patients? |
|
Definition
|
|
Term
| According to the ADA, what postprandial glucose level is an appropriate goal for DM patients? |
|
Definition
|
|
Term
| According to the ADA, what blood pressure target is appropriate for DM patients? |
|
Definition
|
|
Term
| What is the target goal for LDL's in DM patients (ADA)? |
|
Definition
|
|
Term
| What is the target goal for serum triglycerides in DM patients (ADA)? |
|
Definition
|
|
Term
| What is the target goal for HDL's in DM patients (ADA)? |
|
Definition
|
|
Term
| What is the initial total daily insulin dosage (TDD) in adults and children with type 1 DM? |
|
Definition
| from 0.2-1 units/Kg (0.5-0.8 u/Kg/day). |
|
|
Term
| Basal insulin requirements usually comprise what percentage of insulin TDD? |
|
Definition
|
|
Term
| What anti-hypertensive medication class can mask the symptoms of hypoglycemia? |
|
Definition
|
|
Term
| What drugs/drug-types can potentiate hypoglycemia in diabetic patients? |
|
Definition
| EtOH, MAOIs, sulfa antibiotics, some ACEI's. |
|
|
Term
| What are some drugs that antagonize activity of insulin? |
|
Definition
| CCB's, estrogens, thiazide diuretics, furosemide, and thyroid. |
|
|
Term
| Describe sulfonylureas mechanism of action. |
|
Definition
| Sulfonylureas increase insulin release from the pancreatic beta cells. They also reduce serum glucagon concentrations. Finally, they potentiate insulin action on target tissues. |
|
|
Term
| What's the most common side effect of sulfonylureas: |
|
Definition
| Hypoglycemia, GI (n/v), skin (rash, pruritis). |
|
|
Term
| Name a first generation sulfonylurea. |
|
Definition
| Chlorpropamide (Diabinese), tolazamide, tolbutamide. |
|
|
Term
| Name a second generation sulfonylurea. |
|
Definition
| Glipizide (Glucotrol), glyburide (DiaBeta), glimepiride (Amaryl) |
|
|
Term
| What drug class is metformin (Glucophage)? |
|
Definition
|
|
Term
| About how much does metformin (Glucophage) decrease FSBS & HbA1c? |
|
Definition
|
|
Term
| How does metformin (Glucophage) affect serum triglycerides and HDL's? |
|
Definition
| It decreases serum TG & increases HDL's. |
|
|
Term
| What GI discomforts can metformin cause? |
|
Definition
| metallic taste, loss of appetite, nausea and diarrhea |
|
|
Term
| What adverse reaction of metformin should practitioners be mindful of? |
|
Definition
| Lactic acidosis - watch for SCr>1.5mg/dL (1.4 in females) |
|
|
Term
| What diabetic medication should be held for two days prior to contrast imaging studies? |
|
Definition
|
|
Term
| What drug class are Actos (pioglitazone) and Avandia (rosiglitazone)? |
|
Definition
| Thiazolidinediones (also referred to as glitazones). |
|
|
Term
| What is the black box warning for thiazolidinediones (glitazones) about? |
|
Definition
| CHF exacerbation with thiazolidinedione use |
|
|
Term
| What serum ALT level would be a contraindication to initiation of thiazolidinedione (glitazones) therapy? |
|
Definition
|
|
Term
| What pattern of skeletal injury increases in women on Actos? |
|
Definition
| Increased occurrence rate of arm, hand, and foot fracture. |
|
|
Term
| What drug class should repaglinide (Prandin) and nateglinide (Starlix) be placed in? |
|
Definition
|
|
Term
| What drug class are acarbose (Precose) and miglitol (Glycet) in? |
|
Definition
| alpha-glucosidase inhibitors |
|
|
Term
| How should clinicians teach patients to take alpha glucosidase inhibitors? |
|
Definition
| Take with the first bite of each meal. |
|
|
Term
| Thyroid disorders affect what percentae of the population? |
|
Definition
|
|
Term
| In whom are thyroid disorders more common, men or women? |
|
Definition
| Females are 3-4 times more likely to develop thyroid disease. |
|
|
Term
| How much more potent is T3 than T4? |
|
Definition
|
|
Term
| What is the most common cause of primary hypothyroidism? |
|
Definition
|
|
Term
| What is the average oral dose of levothyroxine? |
|
Definition
|
|
Term
| How long does it take for levothyroxine to reach steady state? |
|
Definition
|
|
Term
| How often are thyroid labs monitored after initiating thyroid replacement therapy? |
|
Definition
| Every 3-6 months the first year, then yearly thereafter. |
|
|
Term
| What is the most frequent cause of hyperthyroidism? |
|
Definition
|
|
Term
| What drug class is used to prevent thyroid hormone synthesis & how many weeks until a euthyroid state is reached? |
|
Definition
|
|
Term
| What are 2 drugs in the thioamide class? |
|
Definition
| Propylthiouracil (PTU) and methimazole (Tapazole). |
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