NRSG265 MEDICAL DETAILED EXAM 2025

How does the body regulate BGL for hyperglycemia? - Correct Answer-Pancreatic B cells release insulin Stimulates glucose uptake How does the body regulate BGL for hypoglycemia? - Correct Answer-Pancreatic a cells release glucagon Stimulates release of glucose Ideal BGL range - Correct Answer-4-6mmol/L Which organ produces insulin? - Correct Answer-Pancreas Which organ breaks down stored glycogen? - Correct Answer-Liver breaks down stored glycogen and converts to glucose What is type 1 diabetes? - Correct Answer-autoimmune destruction of beta cells Patho of type 1 diabetes - Correct Answer-Immune response destroys beta cells Lack of insulin released GLUT-4s not activated No glucose uptake Liver continues releasing glucose Causes hyperglycaemia Early Signs and symptoms of Type 1 Diabetes - Correct Answer-polydipisa, polyuria, polyphagia, fatigue Later signs and symptoms of Type 1 Diabetes - Correct Answer-Ketotic breath (metallic taste) Metabolic acidosis (pH lower than 7.35) MoA Insulin - Correct Answer-stores glucose in muscles and liver inhibits glucose production stimulates protein synthesis stores glucose in adipose tissue allows glucose uptake in cells for ATP production Name one rapid acting insulin drug - Correct Answer-Novolog Name one short acting insulin drug - Correct Answer-Actrapid Most common insulin for T1 diabetics - Correct Answer-actrapid Most common insulin for T2 diabetics - Correct Answer-metformin What is diabetic ketoacidosis? - Correct Answer-build up of glucose in blood due to lack of insulin Lab markers of DKA - Correct Answer-BGL over 11mmol/L Ketones in blood and urine pH less than 7.35, HCO5 less than 15mmol/L High serum osmolality Early signs and symptoms of DKA - Correct Answer-polydipsia, polyuria, fruity breath Management of DKA (3 steps) - Correct Answer-1. Fluid resuscitation for 24-72 hours (cerebral oedema risk) 2. Reverse ketosis - insulin infusion 3. Acid base and electrolyte corrections - What is Type 2 Diabetes? - Correct Answer-insulin resistance and relative insulin deficiency patho of type 2 diabetes - Correct Answer-insulin resistance at cell reduction in number of insulin binding sites less insulin binding impaired glucose uptake Treatment of Type 2 diabetes - Correct Answer-Diet Exercise Monitoring BGL Insulin Prevention MoA - metformin - Correct Answer-Decreases hepatic glucose production and intestinal glucose absorption; increase insulin sensitivity Hypersmolar hyperglycaemic state (HHS) - Correct Answer-hyperglycaemia hypervolaemia HHS patho - Correct Answer-Severe hyperglycaemia causes glucose excretion in urine Causes diuresis increased blood osmolality Fluid loss Lab markers of HHS - Correct Answer-BGL over 30mmol/L pH greater than 7.35, HCO3 greater than 15 High Serum Osmolality management of HHS - Correct Answer-1. correction of dehydration - 24-72hours 2. reverse hyperglycaemia - dextrose infusion 3. acid base and electrolyte correction how to correct electrolytes - Correct Answer-Monitoring BGL's, urine ketones, monitoring Na+ and K+ Cause of hypoglycaemia - Correct Answer-Medication overdose Not eating Excess alcohol Excess exercise Malnutrition signs of hypoglycemia - Correct Answer-BGL less than 4 mmol/L Sweating pale Vision changes Management of hypoglycaemia - Correct Answer-monitor BGL 15-20grams of fast carbs 20 grams of slow acting carbs Microvascular complications of diabetes - Correct Answer-retinopathy, nephropathy, neuropathy Macrovascular complications of diabetes - Correct Answer-Atherosclerosis, coronary artery disease, cerebrovascular disease Patho of atherosclerosis in diabetes - Correct Answer-1. toxic metabolites bind to cells which release inflammatory cells - causing vascular permeability 2. monocytes and LDLs move into endothelial layer - macrophages engulf LDLs 3. Foam cells are produced and rupture, causing plaque formation What is diabetic retinopathy - Correct Answer-damage to the blood vessels in the retina what is diabetic nepropathy? - Correct Answer-increased blood viscosity which causes renal system to compensate resultant in renal failure what is diabetic neuropathy? - Correct Answer-decreased blood to nerves causing demyelination Cause of peripheral vascular disease as an outcome of diabetes - Correct Answer-Blood vessel obstruction and thrombus formation causes disruption to peripheral perfusion results in necrosis of tissues - gangrene - amputation Why is there an increased risk of infection associated with diabetes - Correct Answer-Neuropathy causes decreased pain sensation Skin breakages lead to reduced inflammatory response High glucose environment sustains microorganisms Regular investigations for long term diabetes - Correct Answer-Retinal screening Feet checks HbA1c Urine ACR GFR BP Lipid Profile Where is the central controller (respiratory centre) located - Correct Answer-Brain stems (pons, medulla) and cerebral cortex What are the sensors of chemical regulation of respiration - Correct Answer-Chemoreceptors monitor pH, PaCO2 and Pa02 of arterial blood senses changes and diffuses CO2 across BBB What is asthma - Correct Answer-A heterogeneous disease characterised by chronic airway inflammation Patho of Asthma - Correct Answer-Exposure causes IgE antibodies IgE antibodies bind to mast cells Re-exposure causes activation and rupture or Mast cell degranulation within lung tissue causes chemical release histamine - oedema of airways leukotrienes - bronchoconstriction Clinical manifestations of asthma - Correct Answer-wheezing, cough, dyspnea, chest tightness Treatment goal of asthma - Correct Answer-Control symptoms and maintain airway during attacks Prevention of asthma - Correct Answer-Test peel expiratory rate and avoid triggers management of asthma - Correct Answer-develop asthma action plan educate the pt/family/school about triggers and interventions