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Endocrinology | Medicine (MD/DO) School Study Aid


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Diabetes Mellitus
17 Picmonics to Learn | 34 mins

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Proliferative Diabetic Retinopathy
Characteristics
Angiogenesis
Increased VEGF
Asymptomatic Until Late-stage
Fundoscopic Findings
Vitreous Hemorrhage
Retinal Detachment
Glaucoma
Findings of Nonproliferative Diabetic Retinopathy
Management
Laser Photocoagulation
Surgery
Bevacizumab
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2 mins
Diabetes Assessment
Assessment Type 1
Juvenile Onset
Absent Insulin Production
Ketosis Prone
Assessment Type 2
Adult Onset
Insulin Resistance
Obesity
Gestational Diabetes
Onset During Pregnancy
Glucose Intolerance
Complications
Retinopathy
Peripheral Vascular Disease
Nephropathy
Neuropathy
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2 mins
Oral Glucose Tolerance Test (OGTT)
Used for Diabetes Screening
Fasting State
Samples Drawn
Baseline
Normal < 100 mg/dL
30 and 60 Minutes
Normal < 200 mg/dL
120 Minutes
Normal < 140 mg/dL
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2 mins
Diabetic Ketoacidosis (DKA) Signs and Symptoms
Kussmaul respirations
Dehydration
Abdominal Pain
Nausea/vomiting
Psychosis
Fruity breath Odor
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1 min
Diabetic Ketoacidosis (DKA) Diagnosis and Labs
Diagnosis
Blood glucose Increased > 250 mg/dL
Anion gap metabolic acidosis
Decreased pH < 7.3
Decreased serum bicarbonate < 18
Plasma ketones
Other Labs
Hyperkalemia
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1 min
Diabetic Ketoacidosis (DKA) Treatment
Initial Management
IV Normal Saline
Regular Insulin Drip
Subsequent Management (correction of electrolytes)
Potassium (K+)
Glucose
Treat Underlying Cause
Monitoring
Venous pH
Serum Bicarbonate (HCO3)
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1 min
Diabetic Glomerulonephropathy
Pathophysiology
Nonenzymatic Glycosylation of Glomerular Basement Membrane
Nonenzymatic Glycosylation of Arterioles
Hyperfiltration
Increased GFR
Histological Findings
Hyaline Arteriolosclerosis
Mesangial Expansion
Type IV Collagen Deposition
Kimmelstiel Wilson Lesions
Presentation
Nephrotic
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2 mins
Dawn Phenomenon
Cause/Mechanism
Increased Hormone Production
Assessment
Hyperglycemia Upon Awakening
Interventions
Long-Acting Evening Insulin
Change Administration Times
Insulin Pump
Considerations
Closely Monitor Glucose Levels
Between 2-6AM
Limit Carbohydrates Before Bedtime
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2 mins
Corrected Na+ for Hyperglycemia
Equation
[(Glucose-100) * 0.016 ] + Na+
Steps
Glucose-100
Multiply * 0.016
Add Na+
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1 min
Diabetes Education
Self-Monitoring (Blood Glucose)
SubQ Injection Technique
Lifestyle Changes
Symptoms of Hyperglycemia and Hypoglycemia
Sick Day Care
Foot Care
Exercise Therapy
Medication
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1 min
Metabolic Syndrome
Assessment
Dyslipidemia
Central Obesity
Insulin Resistance
Hypertension
Increased C-Reactive Protein (CRP)
Increased Fibrinogen
Considerations
Increased Risk Cardiovascular Disease
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1 min
Gestational Diabetes
Signs and Symptoms
Usually Asymptomatic
Fetal Macrosomia
Polyhydramnios
Diagnosis
Glucose Intolerance After 24 Weeks Gestation
3-hr 100g Glucose Tolerance Test
Treatment
Diet and Exercise
Close Glucose Monitoring
Insulin
Ultrasound (or Nonstress Test (NST))
Delivery
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2 mins
Acanthosis Nigricans
Associations
Endocrine Disorders
Diabetes Mellitus
Obesity
Malignancy
Presentation
Velvety Plaques
Dark, Thickened Flexural Areas
Diagnosis
Hyperkeratosis with Melanocytes
Treatment
Treat Underlying Disorder
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2 mins
Hyperosmolar Hyperglycemic State
Characteristics
Insulin Present
Increased Serum Osmolality
Glucose >600 mg/dL
No Significant Acidosis or Ketosis
Clinical Features
Severe Dehydration
Altered Neurological Status
Tachycardia and Hypotension
Management
IV Fluids
Insulin
Treat Underlying Disorder
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3 mins
Nonproliferative Diabetic Retinopathy
Characteristics
Increased Capillary Permeability and Leakage
Often Asymptomatic
Fundoscopic Findings
Retinal Microaneurysms
Flame-shaped Hemorrhages
Cotton Wool Spots
Hard Exudates
Macular Edema
Management
Treat Diabetes
Laser Photocoagulation
Bevacizumab
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3 mins
Pregnant Diabetic Patient Interventions
First Trimester
Increase Insulin then Decrease
Metformin
Nutrition
Exercise
Second Trimester
Increase Insulin
More Likely to Develop Hypoglycemia than Hyperglycemia
Third Trimester
Double or Quadruple Insulin
Early Delivery
Postpartum
Drastically Decrease Insulin
Monitor Neonate for Hypoglycemia
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3 mins
Diabetes Interventions
Early Diagnosis
Insulin
Oral Hypoglycemics
Glucose Monitoring
Routine Exercise
Diabetic Diet
Monitor for Complications
Insulin Therapy
Diabetic Ketoacidosis (DKA)
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2 mins

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