HONDROS 212 EXAM 3 QUESTIONS
WITH COMPLETE SOLUTION
sleep apnea, asthma, pulmonary HTN, menstrual irregularities, infertility, gestational diabetes,
huperlipidemia, sudden cardiac death, a fib, HTN, CAD, DVT, right sided HF, NASH, gallstones, GERD,
kidney cancer, CKD, esophagus, pancreas, thyroid, colorectal and gallbladder cancer, breast and ovarian
cancer
Nutritional therapy for obesity - Restricting dietary intake so that it is below energy requirements-
includes all food groups
Criteria guidelines for bariatric surgery - BMI of 40 or more or a BMI of 35 or more with other significant
co-morbidities (HTN, T2DM, HF, sleep apnea)
Disadvantages of Roux-en-Y gastric bypass - Leak at site of anastomosis, anemia, calcium deficiency,
dumping syndrome, irreversible
Dumping syndrome - Gastric contents empty too rabidly into the small intestine, overwhelming its ability
to digest nutrients. Symptoms include n/v, weakness, sweating, faintness and sometimes diarrhea. Pt is
instructed to avoid sugary foods after surgery
Anastomosis leak - tachycardia, fever, tachypnea, chest and abdominal pain
Post operative care for bariatric surgery - assess for cardiopulmonary complications, thrombus
formation, anastomosis leaks and electrolyte imbalances, maintain the head of the bed at a minimum of
a 45 degree angle to reduce abdominal pressure and increase lung expansion, pts should not consume
fluids with meals
Metabolic syndrome definiton - is a group of metabolic risk factors that increase a person's change of
developing CVD, stroke, diabetes. It is a cluster of heath problems, including obesity, HTN, abnormal lipid
levels, and high blood glucose
The main underlying risk factor for metabolic syndrome - Insulin resistance related to excess visceral fat
Criteria for metabolic syndrome - Need any 3 of the 5- waist circumference- >40in in men and >35 in
women, Triglycerides- >150 or on drug treatment for high triglycerides, HDL cholesterol- <40 in men <50
in women or drug treatment for high cholesterol, BP- >130 sys >85 diastolic or on drug treatment for
HTN, fasting blood glucose >100 or on drug treatment for elevated blood glucose
Signs and symptoms of metabolic syndrome - Impaired fasting blood glucose, HTN, abnormal cholesterol
levels and obesity
counterregulatory hormones- increase blood glucose levels - glucagon, epinephrine, GH, cortisol
C peptide in serum and urine - useful clinical indicator of pancreatic b cell function and insulin levels
, Signs and symptoms of type 1 diabetes - polyuria, polydipsia, polyphagia, weight loss may occur,
weakness and fatigue
signs and symptoms of type 2 diabetes - poor wound healing, recurrent infections, dry skin, 3 Ps,
drowsiness, hunger
Diagnosis of diabetes - A1C of 6.5 or higher, fasting plasma glucose level of 126 or greater, a 2 hour
plasma glucose level of 200 or greater during an OGTT using a glucose load of 75g, in a pt with classic
symptoms of hyperglycemia (polyuria, polydipsia, unexplained weight loss) or hyperglycemic crisis, a
random blood glucose level of 200 or more
A1C (glycosylated hemoglobin) - provides a measurement of blood glucose levels over the previous 2 to
3 months
Diseases affecting RBCs (anemia) can influence the AIC
Goal A1C for pts with diabetes - less than 7.0
Fructosamine - Is another way to assess glucose levels,, reflects glycemia in the previous 1 to 3 weeks
Islet cell antoantibody - testing is primarily done to help distinguish between autoimmune type 1
diabetes and diabetes from other causes
Rapid acting insulin (lispro, aspart) - Onset 10-30 min
Peak- 30 min- 3hr
Duration- 3 - 5 hour
Short acting (regular Humulin R, Novolin R) - Onset 30min- 1hr
Peak- 2-5hr
Duration- 5-8hr
ONLY INSULIN THAT CAN BE GIVEN IV!!
Intermediate acting insulin (NPH) - Onset- 1.5-4hr
Peak- 4-12hr
Duration- 12- 18hr
Gently agitate before administering
Long acting insulin (glargine, detemir) - Onset- 0.8-4hr
no peak
Duration- 16-24hr
DO NOT MIX WITH ANY OTHER INSULIN
Lipodystrophy - loss of subcutaneous tissue may occur if the same injection sites are used
WITH COMPLETE SOLUTION
sleep apnea, asthma, pulmonary HTN, menstrual irregularities, infertility, gestational diabetes,
huperlipidemia, sudden cardiac death, a fib, HTN, CAD, DVT, right sided HF, NASH, gallstones, GERD,
kidney cancer, CKD, esophagus, pancreas, thyroid, colorectal and gallbladder cancer, breast and ovarian
cancer
Nutritional therapy for obesity - Restricting dietary intake so that it is below energy requirements-
includes all food groups
Criteria guidelines for bariatric surgery - BMI of 40 or more or a BMI of 35 or more with other significant
co-morbidities (HTN, T2DM, HF, sleep apnea)
Disadvantages of Roux-en-Y gastric bypass - Leak at site of anastomosis, anemia, calcium deficiency,
dumping syndrome, irreversible
Dumping syndrome - Gastric contents empty too rabidly into the small intestine, overwhelming its ability
to digest nutrients. Symptoms include n/v, weakness, sweating, faintness and sometimes diarrhea. Pt is
instructed to avoid sugary foods after surgery
Anastomosis leak - tachycardia, fever, tachypnea, chest and abdominal pain
Post operative care for bariatric surgery - assess for cardiopulmonary complications, thrombus
formation, anastomosis leaks and electrolyte imbalances, maintain the head of the bed at a minimum of
a 45 degree angle to reduce abdominal pressure and increase lung expansion, pts should not consume
fluids with meals
Metabolic syndrome definiton - is a group of metabolic risk factors that increase a person's change of
developing CVD, stroke, diabetes. It is a cluster of heath problems, including obesity, HTN, abnormal lipid
levels, and high blood glucose
The main underlying risk factor for metabolic syndrome - Insulin resistance related to excess visceral fat
Criteria for metabolic syndrome - Need any 3 of the 5- waist circumference- >40in in men and >35 in
women, Triglycerides- >150 or on drug treatment for high triglycerides, HDL cholesterol- <40 in men <50
in women or drug treatment for high cholesterol, BP- >130 sys >85 diastolic or on drug treatment for
HTN, fasting blood glucose >100 or on drug treatment for elevated blood glucose
Signs and symptoms of metabolic syndrome - Impaired fasting blood glucose, HTN, abnormal cholesterol
levels and obesity
counterregulatory hormones- increase blood glucose levels - glucagon, epinephrine, GH, cortisol
C peptide in serum and urine - useful clinical indicator of pancreatic b cell function and insulin levels
, Signs and symptoms of type 1 diabetes - polyuria, polydipsia, polyphagia, weight loss may occur,
weakness and fatigue
signs and symptoms of type 2 diabetes - poor wound healing, recurrent infections, dry skin, 3 Ps,
drowsiness, hunger
Diagnosis of diabetes - A1C of 6.5 or higher, fasting plasma glucose level of 126 or greater, a 2 hour
plasma glucose level of 200 or greater during an OGTT using a glucose load of 75g, in a pt with classic
symptoms of hyperglycemia (polyuria, polydipsia, unexplained weight loss) or hyperglycemic crisis, a
random blood glucose level of 200 or more
A1C (glycosylated hemoglobin) - provides a measurement of blood glucose levels over the previous 2 to
3 months
Diseases affecting RBCs (anemia) can influence the AIC
Goal A1C for pts with diabetes - less than 7.0
Fructosamine - Is another way to assess glucose levels,, reflects glycemia in the previous 1 to 3 weeks
Islet cell antoantibody - testing is primarily done to help distinguish between autoimmune type 1
diabetes and diabetes from other causes
Rapid acting insulin (lispro, aspart) - Onset 10-30 min
Peak- 30 min- 3hr
Duration- 3 - 5 hour
Short acting (regular Humulin R, Novolin R) - Onset 30min- 1hr
Peak- 2-5hr
Duration- 5-8hr
ONLY INSULIN THAT CAN BE GIVEN IV!!
Intermediate acting insulin (NPH) - Onset- 1.5-4hr
Peak- 4-12hr
Duration- 12- 18hr
Gently agitate before administering
Long acting insulin (glargine, detemir) - Onset- 0.8-4hr
no peak
Duration- 16-24hr
DO NOT MIX WITH ANY OTHER INSULIN
Lipodystrophy - loss of subcutaneous tissue may occur if the same injection sites are used
