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Terms
45
Health Care
Professional
03/04/2015

Additional Health Care Flashcards

 


 

Cards

Term
DKA
Definition
-Glucose unable to travel into cell.
-BGLs >250.
-Causes dehydration, ketosis, electrolyte imbalance and acidosis.
Term
Amylin
Definition
-Secreted by Beta-cells and insulin in response to nutrient intake.
-In the PP period, slows gastric emptying,
-suppresses Glucagon secretions, -lowers hepatic glucose production.
Term
Glucagon
Definition
-Hormone produced by Alpha cells of Islets of Langerhans.
-Counter regulatory hormone to insulin.
-Results in an increase in circulating glucose levels by stimulating gluconeogenesis.
Term
Dawn Phenomenon
Definition
-Increased AM BGL levels.
-Caused by NPH use at supper time resulting in peak effect during early hours and in AM.
-Most agreed upon reason for pts to get the CSII/Pump.
Term
DM 1
Stage 1: Genetic Predisposition
Definition
-Genetic Predisposition
-Related to combination of HLA-DQ coded genes that have DM susceptibility to those with DM resistance.
-Also HLA genotype.
Term
GDM Risk Factors
Definition
->25 yo,
-Obese,
-racial/ethnic background,
-Hx of abnormal glucose tolerance,
-1st degree relative with DM I
Term
GDM Fetal Risk
Definition
-Macrosomia (>90th %)
-Higher risk for developing DM
-Shoulder dystocia, Brachial plexis, -ERB Palsy, Asphxia.
-Neo-Natal hypoglycemia BS <40.
-Respiratory distress syndrome
-Hyperbilirubinemia
-Increased BMI
Term
GDM maternal complications
Definition
-HTN
-Polyhydramnios
-C-section
Term
Creatinine
Definition
-Nitrogen formed from mm Metabolism.
-Normal: 0.5-1.4
-Males have higher levels.
-Increases with Kidney function disease.
Term
BUN
Definition
-Blood Level of Urea.
-Byproduct of protein metabolism.
-Normal: 8-20
-Levels increase with Kidney Dx.
Term
HHS
Definition
-Hyperosmolar Hyperglycemia State:
-High BGLs + Dehydration
-BGL >600, yet Minimal Ketones.
-Primarily: Undiagnosed DM II, Elderly.
-More life threatening than DKA.
Term
Glucogen
Definition
-Complex CHO.
-Primary storage form of Glucose in Liver + Muscle.
Term
Gestational DM
Definition
-Test at 27 weeks.
-Ingest 100 g Oral Glucose +:
>92 fasting
>196 1 hour
>171 2 hours
>140 3 hours
Term
Ketosis
Definition
-Ketones produced during DKA.
-Acetoacetate converts to acetone and is excreted by lungs.
-Causes fruit smell on breath.
Term
HHS Primary Markers
Definition
-Severe Hyperglycemia: BGL >600.
-Dehydration, Plasma Osmolality >320.
-Neurologic changes (mimic CVA).
-Absence of significant Ketones.
Term
Acidosis
Definition
-Deep/Rapid breathing
Term
Gestational Diabetes Disease Initiation
Definition
-Glucose intolerance (4% pregnant women).
-Risk assessment completed at 1st prenatal visit.
-Those w/ clinical signs: glucose test.
-Negative high risk women should be retested at 24-28 weeks gestation.
Term
Hgb A1c as diagnostic tool
Definition
-Regular: <5.7%
-Pre-DM: 5.7-6.4%
-DM: >=6.5%
Term
Type I DM, Pathophysiology
Definition
-Stage 1: genetic predisposition.
-Stage 2: Environmental trigger.
-Stage 3: Active Auto-Immunity.
-Stage 4: Progressive Beta-Cell dysfunction.
-Stage 5: Overt DM
Term
MODY (DM)
Definition
-Known genetic defects associated with glycogen synthase deficiency, and Mitochondrial DNA markers.
Term
Pancreatic Disorders (DM)
Definition
-Hemochromatosis
-Chronic Pancreatitis
-Pancreatectomy
Term
Hormonal Disorder (DM)
Definition
-Cushings
-Acromegaly
Term
Other Forms of Diabetes
Definition
-Cystic Fibrosis
-Congenital Rubella Syndrome
-Down Syndrome
Term
Drugs that "cause" Diabetes
Definition
Steroids:
-Glucocorticoids
Term
Type 2 DM
Percent Risk w/ Family History
Definition
-15% risk of DM
-30% risk of IGT
-Identical twins risk 90% if 1 twin w/ DM
Term
DKA Therapy
Providing Glucose
Definition
-Once BGL lowers to 250, add 5-10% Dextrose to IVF.
-Starvation perpetuates Ketosis.
-Sudden drops in Glucose can be a/w cerebral edema.
Term
Gestational DM
Hallmark
Definition
-Failure to augment beta-cell insulin response to the insulin resistance.
Term
Incretin Hormones
Intestinal
Definition
-Both make Beta-cells more sensitive to higher BGLs:
-GIP: Glucose dependent insulin releasing poly-peptide.
-GLP: Glucagon-like peptide.
Term
Type 2 DM
Risk Characterizations
Definition
-Obesity, Sedentary lifestyle
-Hx HTN, Dislipidemia
-Family Hx of DM, Gestational Hx
-Ethnicity
Term
Islet Cell Antibody
Best Predictor of future DM I
Definition
GAD: Glutamic acid decarboxylase
Term
Genetic Risk Factors for DM
vs
Lifestyle
Definition
-Genetic factors important for DMII,
BUT
-Lifestyle largely regulates gene expression in determining DM development.
Term
DM I Classification
Definition
-Result of Auto-Immune Beta-cell destruction.
-Absolute Insulin deficiency.
Term
DM II Classification
Definition
-Multihormomal
-Involving a progressive insulin secretory defect +
-Insulin resistance and obesity
Term
Progression/Prevalence of DM II
Definition
* 90% of DM is type 2
* Elderly, Ethnic
* Asymptomatic when Diagnosed
* Endogenous Insulin may be Normal, yet have variable need of Exogenous insulin.
* Insulin resistance occurs early
* Not prone to Ketosis
* 50% men, 70% women are obese
Term
DM 1
Stage 2: Environmental triggers
Definition
* Viral, Bottle Feeding.
* Sex steroids in puberty/pregnancy.
* Incidence of DM 1 increases in Spring and Fall.
- Long latency period makes finding cause harder.
Term
DM 1
Stage 3: Active Autoimmunity
Definition
-Autoimmune attack of Beta-cells.
-Glutamic Acid Decarboxylase (GAD):
Best predictor.
-Immune attack on Insulin
-Beta cell destruction is slower in adults.
- Higher BGLs and S/S occur when >90% B-cells have been destroyed.
Term
DM 1
Stage 4: Progressing Beta-Cell Dysfunction
Definition
-Quick clinical onset
-Can be brought upon by acute illness/stress 2/2 increased insulin demand.
-Higher BGLs will control until stress/illness resolved
-HoneyMoon Period: Non-insulin dependent. Lasts approx 3-12 months
Term
Hormones and Factors Influencing
Fuel Metabolism:
Peptide YY
Definition
Reduces food intake via brain receptors
Term
Hormones and Factors Influencing
Fuel Metabolism:
Endocannabinoid System
Definition
-Physiological regulation of energy balance, Food intake, Lipid and Glucose metabolism
-Over-activation = Obesity
Term
Gluconeogenesis
Definition
-Process of Glucose Production by the Liver
-Precursors: Lactate, Amino Acids
Term
DKA electrolyte imbalances:
Sodium
Definition
Dehydration causes profound loss of total body sodium that can't be measured
Term
DKA electrolyte imbalances:
Potassium
Definition
-Always depletes with DKA
-Lab values can be Iffy
-May be low before therapy as it enters the cell
-Check renal function
-Phosphate typically high, then decreases
Term
Adipocyte
Definition
-Fat cell for storage of excess kcals
-Source of hormones and cytokins that control:
appetite
weight
inflammation
intermediary metabolism
Term
Latent Auto-Immune Diabetes of Adults
Definition
-Slow progressive form of Type 1
-Frequently mistaken for Type 2
-May do with NO insulin for several years
-Beta cell deterioration
Term
Glutamic Acid Decarboxylase
Definition
-Protein that appears to be the best immunologic predictor of future type 1 Diabetes development.
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