NR571 FINAL DM EXAM QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES

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Diabetic complications: kidney failure, nontraumatic limb amputation, adult blindness, heart disease, stroke. (DKA) and (HHS) are two life-
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threatening complications with diabetes are complications
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1. Glucose Production and Release: glucose found in carbohydrates, stores in the liver rel
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eased in bloodstream, for constant source of energy are
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2. Insulin Release in Type I Diabetes: high glucose in blood, stimulate beta cells-
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release insulin, Insulin stops the release of glucose, small amount stores in liver, beta cells damaged/
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destroyed no insulin produced are jv jv jv jv




3. Systemic Insulin and Glucose in Type I Diabetes: low insulin production, low ins jv jv jv jv jv jv jv jv jv jv jv jv



ulin and jv




high glucose in their blood are
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4. Glucose Absorption in Type I Diabetes: Insulin is needed for glucose to enter cells fo
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r energy, insulin binds to receptors on the cell surface, initiates glucose transporters to open and glucose to
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flow into the cell. low insulin prevents enough glucose from entering the cell. Glucose remains in bloodstrea
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m not for energy, patients are fatigue, exhaustion, and dizziness.
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5. Glucose Absorption in Type II Diabetes=: Due to insulin resistance and resulting h
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yper-
glycemia, patients with type 2 diabetes increased thirst or hunger, fatigue, blurry vision, and slow-
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healing wounds. jv




6. Beta-blocker for thyroid storm: Given to reduce sympathetic stimulation- jv jv jv jv jv jv jv jv




Primary agents include: (Esmolol IV for rapid titation; Bisoprolol PO)
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7. Thionamide for thyroid storm: Given to correct hyperthyroid state (High- jv jv jv jv jv jv jv jv jv



dose methimazole or PTU) jv jv jv




8. Iodine compounds for thyroid storm: Blocks release of thyroid hormones, given 1
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hour after starting antithyroid therapy (SSKI or Lugol's iodine drops)
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9. Glucocorticoids for thyroid storm: Decreases conversion of T4 to T3 (IV hydrocor jv jv jv jv jv jv jv jv jv jv jv




tisone or dexamethasone) jv jv




10. Meds for thyroid storm: Beta- jv jv jv j v




blocker, Thioamides, Iodine compounds, and Glucocorticoids are meds for
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11. PTU: the antithyroid medication of choice in pregnant pts is jv jv jv jv jv jv jv jv jv



12. glucocorticoids and iodine: meds for thyroid storm, they do not need to be conti jv jv jv jv jv jv jv jv jv jv jv jv jv




nued once the emergent situation is resolved.
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13. Hypothyroidism s/ jv




s: underproduction of the hormone thyroxine (T4), body's metabolism slows down, symptoms-
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fatigue, depressed mood, slow heart rate, constipation, weight gain, and irregular menstrual periods.
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>women and family history is
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14. Somogyi effect and dawn phenomenon: Elevated blood glucose levels are see
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n at 0700 with
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15. metformin: Monotherapy with ? jv jv jv




is the drug of choice when initiating drug therapy in a type 2 diabetic according to all clinical practi
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ce guidelines. jv




16. lifestyle recommendations for DM: Weight loss, Regular exercise, Medical nu jv jv jv jv jv jv jv jv jv




trition therapy (nutritionist), , Adequate sleep, ,Smoking cessation, Behavioral support groups, Diabetic
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educator are consider for jv jv jv




17. DKA symptoms: polyuria & polydipsia, weakness/ jv jv jv jv jv




fatigue, nausea & vomiting, Kussmaul respirations, altered loc, fruity breath
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18. DKA labs results: hyperglycemia (usually > 300 mg/ jv jv jv jv jv jv jv




dL), ketonuria, metabolic acidosis, high anion gap, elevated hematocrit, azotemia,
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19. Pathology of HHS: intracellular dehydration, complication of T2DM, hyperglycemia, os jv jv jv jv jv jv jv jv jv




motic diuresis, and extracellular fluid depletion, due to non-
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compliance or "stretch" their medication is the jv jv jv jv jv jv




20. HHS symptoms: polyuria, weakness, changes in LOC, hypotension, tachycardia, poor
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skin turgor are symptoms of
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21. HHS lab results: (> 600 mg/dL), hyperosmolality (> 320 mOsm/ jv jv jv jv jv jv jv jv jv




L), elevated HbA1C, normal pH, no ketonuria, normal anion gap are lab
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22. anion gap: the ditterence between positively and negatively charged electrolytes responsible
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for maintaining acid-base balance.
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23. Serum anion gap: Na+ - (Cl- + CO2-) is the calculation for jv jv jv jv jv jv jv jv jv jv jv



24. High-anion-
gap metabolic acidosis: ketoacidosis, lactic acidosis, severe chronic renal failure, toxic ing
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estion are due to jv jv jv




25. Non-anion-
gap metabolic acidosis: diarrhea, nephrotic syndrome, renal tubular acidosis, renal failure,
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acetazolamide, adrenal insuflciency are due to jv jv jv jv jv




26. non-
anion gap metabolic acidosis exists: calculate the urine anion gap by measuring urin
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e electrolytes should do to help narrow the ditterential if
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27. DKA and HHS most common: precipitating factor in both conditions is infection, CV
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A, MI, alcohol abuse, pancreatitis, trauma, and noncompliance with medication.
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28. Work up for DKA and HHS: CBC (hemoglobin and WBCs), CMP (electrolytes, renal jv jv jv jv jv jv jv jv jv jv jv jv j




function, and calculated anion gap), serum osmolality, ABG (pH, HCO3, pCO2, pO2), lactic acid, beta-
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