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AG-ACNP – Endocrine: Questions & Solutions (100%)
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AG-ACNP – Endocrine: Questions & Solutions (100%)
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AG-ACNP – Endocrine: Questions & Solutions (100%)What is the pathology of diabetes mellitus? Right Ans - Metabolic disease
resulting from a breakdown in the body's ability to produce or utilize insulin
causing hyperglycemia.
Explain the pathology of DM Type 1. Right Ans - Insulin DEPENDENT. Total
destruction of beta cells.
Islet cell antibodies - 90% of patients
Ketone development occurs
What are the signs and symptoms of DM Type I? Right Ans - Polyphagia
Polydypsia
Polyuria
Weight loss
What are the labs/diagnostics indicative of DM Type I? Right Ans - Random
BG - > 200 mg/dL
Fasting BG - > 126 mg/dL x 2 separate occasions
HgbA1c - routine diagnostic; > 7%
BUN/Cr elevated due to dehydration
Ketonemia, ketonuria
What pharmacological therapy is indicated if the patient presents with
ketones and DM Type I? Dose? Right Ans - Insulin therapy.
TDD - 0.5 units/kg/day
2/3 TDD in am and 1/3 in pm
What is the Conventional Split Dose Mixtures for insulin administration?
Right Ans - Morning dose of insulin - 2/3 NPH, 1/3 Regular
Evening dose of insulin - 1/2 NPH, 1/2 Regular
Identify the three Insulin Analogs. Right Ans - Aspart (NovoLog)
Glargine (Lantus) - prolonged duration
Lispro (Humalog) - rapid onset
What is the pathology of DM Type II? Right Ans - Circulating insulin is not
enough to meet patient's needs, but enough to prevent ketoacidosis. Caused
by tissue insensitivity or resistance/impaired insulin production.
, Define the criteria for diagnosing Metabolic Syndrome. Right Ans - Any of
the 3:
- Waist circumference: M > 40 in, F > 35 in
- BP > 130/85
- Triglycerides > 150
- FGB > 100
- HDL: M <40, F < 50
40 yo. F presented to ED with complaints of four UTIs in the past 6 months
and chronic skin infection, with increasing pruritus. What is most likely
differential? Right Ans - DM Type II. Women present with reoccuring
vaginitis and chronic skin infections.
What is the initial therapy indicated for managing DM Type II? Right Ans -
Weight loss for obese patients and use of oral agent
What is the standard of care in pharmacological management of newly
diagnosed Type II diabetic patient? Right Ans - Metformin (Glucophage)
What is a major side effect of Metformin (Glucophage)? Right Ans - Lactic
Acidosis.
Patient complains of muscle cramps and pain - think LA.
Glipizide (Glucotrol) and Glyburide (Diabeta) are examples of what type of
medication? What is the mechanism of action? Right Ans - Sulfonylureas -
stimulate the pancreas to release more insulin.
A key feature of DM Type II is Metabolic Syndrome. To make this diagnosis,
you need three of the following EXCEPT:
a. Waist circumference M > 40, F > 35
b. BP > 140/90
c. Fasting BG >100
d. HDL M <40, F <50 Right Ans - B. The BP in Metabolic Syndrom is
>135/85.
What is the contribution of incretins in the management of diabetes? Right
Ans - Incretins - signal the pancreas to increase insulin secretion and the liver
to stop producing glucagon
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