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AG-ACNP Endocrine: Questions And Answers (100% Accurate)
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AG-ACNP Endocrine: Questions And Answers (100% Accurate)
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AG-ACNP Endocrine: Questions And Answers (100%Accurate)
What age group is primarily affected in DM Type 1? Right Ans - Young
people and early adulthood
What antigens are strongly associated with DMI? Right Ans - HLA-DR3 or
HLA-DR4 (human leukocye antigens)
What antibodies are found in 90% of patients within the first year of dx of
DM1? Right Ans - Islet cell antibodies
What is the hallmark difference between DM1 and DM2? Right Ans -
development of ketones in DM1
What are s/s of DM? Right Ans - polyuria
polydipsia
polyphagia
What s/s of DM are primarily found in type 1 DM? Right Ans - nocturnal
emesis
weight loss
weakness/fatigue
What s/s of DM are primarily found in type 2 DM? Right Ans - onset is
insidious
recurrent vaginitis or other chronic skin infxn
blurred vision
peripheral neuropathies
What lab values are typically assc w/Impaired glucose tolerance? Right
Ans - FBG >/100 and </125
If a serum fasting glucose is >? 126 can you diagnose a person w/DM?
Right Ans - No, the fasting glucose needs to be >/126 on two separate
occasions, or a non-fasting blood glucose>/ 200 w/the 3 p's
,Would the BUN/cr be elevated in a DM pt? Right Ans - Yes, ,due to
dehydration
What is the goal for HgA1C? Right Ans - around 6
What is the purpose of the HgA1C? Right Ans - can be used to dx DM
and give indication of glycemic control for the past 2-3months
What is the normal range for HgA1C? Right Ans - 5.5-7
Who has ketones in the blood and urine? Right Ans - Type 1 diabetics
How should treatment for diabetics be determined? Right Ans - It should
be individualized
and done is a step wise fashion
What baseline studies should be obtained for a newly dx DM pt? Right Ans -
*age of onset
*obesity
*Cardiac Risk Factors
*Presence of Ketones
*Diagnostic markers
*Cholesterol, triglycerides, ECG
*Renal Studies (as needed)
*Baseline phys exam, noting peripheral pulses, neurologic fxn, eye and foot
exams.
What consists of the the dietary teaching for diabetics? Right Ans - Total
Carbs 55-60% of total calories
Fats 20-30% of total calories
Fiber 25g/1000 calories
Protein 10-20% of total calories
If a pt presents w/Ketones, what therapy is most likely indicated? Right
Ans - Insulin
What is the general rule of thumb to begin insulin tx for a type 1 dm? Right
Ans - 0.5u/kg/day, giving 2/3 of dose in the morning and 1/3 in the evening
, What is the conventional split dose mixture of insulin? Right Ans - For the
2/3 am dose: 2/3 is NPH and 1/3 is Regular
For the 1/3 pm dose: 1/2 is NPH and 1/2 is Regular
What is the first treatment for a newly dx type 2 diabetic? Right Ans -
Should be Lifestyle changes (diet, exercise, weight control)
*however in practice they may be started on an oral agent in addition to
lifestyle changes
What class of diabetic oral agents are most widely prescribed? Right Ans -
sulfonylureas such as glipizide(glucotrol), glyburide(deabeta) and
glimepiride(amryl)
What is MOA for sulfonylureas? Right Ans - stimulate the pancreas to
release more insulin
What type of oral anti-diabetic medicine stimulates the pancreas to release
more insulin? Right Ans - sulfonylureas
What type of oral anti-diabetic is glipizide, glyburide, and glimepiride?
Right Ans - sulfonylureas
What oral anti-diabetic medication is recommended by the ADA and is the
first line medication for DM2? Right Ans - Metformin(glucophage)
What is a potential side effect of Metformin? Right Ans - lactic acidosis
How would a pt present with lactic acidosis? Right Ans - muscle
ache/weakness
What is an example of a Biguanide? Right Ans - Metformin(glucophage)
What class of medication is Metformin(glucophage)? Right Ans - Biguanide
What is the MOA of Alpha-glucosidase inhibitors? Right Ans - Bind to
disaccharideases more readily than sucrose, so less glucose is absorbed by the
gut
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