5140 Exam 1 Questions with Accurate Answers

Pancreas - ANSWERSWhat organ is responsible for insulin levels? Aplha cells - ANSWERSWhat produces Glucagon? -Stimulates breakdown of glycogen in liver (glycogenolysis) -Stimulates formation of Carbohydrates in Liver -Stimulates breakdown of lipids *Blood glucose level regulate how much glucagon is secreted* - ANSWERSWhat does Glucagon do? Beta cells - ANSWERS-Secrete insulin, which decreases blood glucose -Secretion is regulated by blood glucose levels Delta cells - ANSWERS-Produces somatostatin, which inhibits production of glucagon and insulin -Balances alpha and beta cell function Adrenal glands - ANSWERSWhat releases Epinephrine? Pituitary - ANSWERSWhat releases the Growth Hormone? Adrenal glands - ANSWERSWhat releases Cortisol? Glucagon Epinephrine Growth Hormone Cortisol - ANSWERSWhat hormones cause blood glucose levels to rise? Type 1 Diabetes - ANSWERSInsulin dependent or juvenile onset Diabetes Mellitus Type 2 Diabetes - ANSWERSNon-insulin dependent or adult onset Diabetes Mellitus Also includes Prediabetes and Gestational DM Contributing factors to Type 1 DM - ANSWERS-Strongly inherited -Exposure to virus Contributing factors to Type 2 DM - ANSWERS-Older age -Obesity -Family History -Gestational DM -Physical activity -Certain ethnic populations *90-95% of people with DM* Prediabetes - ANSWERS-OGTT of 140-199 -Fasting Glucose 100-129 -Intermediate stage between homeostasis and diabetes Gestational DM - ANSWERS-Glucose intolerance during pregnancy -Affects 5% of the population -Symptoms disappear after pregnancy Diagnosis of DM - ANSWERS-Fasting glucose > 126 -2 hr post GTT > 200 Somagyi Effect - ANSWERSNight time hypoglycemia after evening doses of insulin cause the counterregulatory hormones to increase blood sugar Dawn Phenomenon - ANSWERSAwakening hyperglycemia caused by growth hormone and cortisol especially in children and adolescents Inhaled Insulin - ANSWERS-Rapid acting insulin that is inhaled -Administered at the beginning of each meal or 20 minutes after starting a meal -Don't give to COPD or asthmatic patients *Not a substitute for long-acting insulin* Oral and Non-insulin injectable agents - ANSWERSWorks on: Insulin resistance Decreased insulin production Increased hepatic glucose production Carbohydrate intake - ANSWERS-Insulin is based on how many carbs are ingested -Adults should keep between 45-60 g -For every 5g, a certain amount of insulin is given Glycemic Index - ANSWERSa method of classifying foods according to their potential for raising blood glucose Diabetic Keotacidosis (DKA) - ANSWERS-Hyperglycemic state with dehydration -Glucose >250 -pH < 7.30 -HCO3 <16 -Characterized by fruity breath, Kussmaul respirations, abdominal pain, N/V, high ketones -Likely in patients with illness or infection Treatment of DKA - ANSWERSFluids, insulin, and aggressive replacement of electrolytes (e.g., K+) Hyperosmolar Hyperglycemic Syndrome (HHS) - ANSWERS-A life threatening syndrome that can occur in the patient with diabetes who is able to produce enough insulin to prevent DKA but not enough to prevent severe hyperglycemia -Extreme hyperglycemia 600-2000mg Treatment of HHS - ANSWERS-Correction of hypovolemia with 0.9% saline IV, usually requires more fluid replacement than DKA -Dextrose IV when BS= 250 Hypoglycemia - ANSWERS-low blood sugar <70 -From too much insulin, too little food, vomiting, alcohol, too much exercise Treatment of Hypoglycemia - ANSWERS-Rule of 15: give 15 g of carbs and recheck in 15 minutes and repeat if still < 70 -If not alert/oriented, give 50% dextrose IV Angiopathy - ANSWERSMacrovascular: occurs before DM symptoms appear, coronary artery disease, hypertension, PVD, CVD, tight glucose monitoring prevents this Microvascular: retinopathy, nephropathy, dermopathy, happens 10-20 years after diagnosis, manage BS