FAMILY MEDICINE AQUIFER/329 QUEST u u u
IONS AND ANSWERS (A+) u u u
What disease can hyperthyroidism unmask? -
u u u u u
√Answer :Diabetes
u u
Unmasks glucose intolerance and adversely effects glucos
u u u u u u
e and lipid management
u u u
Quiz :What diseases are associated with T1D? -
u u u u u u u
√Answer :Hashimotos
u u u
Graves u
*autoimmune diseases* u
Quiz :What is a key component of HHS treatment? -
u u u u u u u u u
√Answer :Fluid replacement
u u u u
In many cases several liters
u u u u
Quiz :What is the most common underlying cause of HHS?
u u u u u u u u u u
- √Answer :Decreased fluid intake
u u u u u
UTI
Pneumonia u
MI, stroke and PE can also precipitate it
u u u u u u u
Quiz :Screening for TIID? - √Answer :Normal starts at 45
u u u u u u u u u u
Or
Overweight with one or more risk factors: u u u u u u u
Physical inactivity u u
High risk ethnicity u u u
,First degree relative with diabetes
u u u u
Impaired glucose previously u u u
Stage 2 hypertension (140/90)
u u u
Low HDL and High TG
u u u u
gestational diabetes u
PCOS
CVD HX u u
acanthosis
Quiz :Symptoms of hyperglycemia -
u u u u
√Answer :Unexplained weight loss
u u u u
Polyuria
Quiz :Dx of diabetes - √Answer :A1C: greater than 6.5
u u u u u u u u u u
2 hour postprandial over 200
u u u u u
Fasting over 126 u u
Random over 200 with symptoms of hyperglycemia
u u u u u u
Quiz :What causes vision changes in someone with diabet
u u u u u u u u
es - u
u√Answer :Darks spots: new blood vessels forming and leak
u u u u u u u u
ing u
Blurriness: macular edema u u u
Vision changes are a late complication of diabetic changes.
u
u u u u u u u u
40% of patients requiring insulin develop retinopathy 5 year
u u u u u u u u
s later
u
Quiz :What do retinal hemorrhages look like and what caus
u u u u u u u u u
es them? - √Answer :Dark blots with indistinct borders—
u u u u u u u u
indicate partial obstruction and infarction
u u u u
,Quiz :What are cotton wool spots and what does it mean? -
u u u u u u u u u u u
√Answer :White spots with fuzzy borders
u u u u u u
Previous areas of infarction, usually with hemorrhages
u u u u u u
Quiz :What do microaneurysms look like in the eye? -
u u u u u u u u u
√Answer :Punctuate dark lesions— well circumscribed
u u u u u u
Quiz :What causes neovascularization? -
u u u u
√Answer :Hypoxia and vessel occlusion
u u u u u
Quiz :Parts of a diabetic foot exam -
u u u u u u u
√Answer :Dorsalis pedis and posterior tib pulses
u u u u u u u u
Ankle jerk reflex u u u
Filament testing u u
Skin for hair loss, breaks in skin, bony prominences etc
u u u u u u u u u
Quiz :What labs should be ordered for someone with diabet
u u u u u u u u u
es that hasn't been seen for a year? - √Answer :A1C
u u u u u u u u u u
Lipid panel u
TSH u
Creatine/ GFR u u
B12 levels (metformin Lowers this)
u u u u u
Spot albumin to creatinine ratio (testing for microalbuminuri
u u u u u u u
a)
Quiz :When should moderate intensity statin be administrat
u u u u u u u
ed? - √Answer :Age 40-75 with LDL over 70 and DM
u u u u u u u u u u
Quiz :When to use high intensity statin? -
u u u u u u u
√Answer :Moderate risk plus 7.5% estimated 10 yr CVD ris
u u u u u u u u u u
k
, Quiz :Goal BP for patients with diabetes? -
u u u u u u u
√Answer :Less than 130/80
u u u u u
(That is stage 1 hypertension)
u u u u
Quiz :Does aspirin decrease risk of heart disease in someo
u u u u u u u u u
ne with diabetes and no other CVD risk factors? -
u u u u u u u u u
√Answer :No
u u
**only give them aspirin if they have hex of CVD... aka over
u u u u u u u u u u u u
50 with HTN, HLD, smoking, microalbuminuria and are not
u u u u u u u u u
at an increase risk of bleeding
u u u u u
Quiz :What A1C is known to decrease microvascular compl
u u u u u u u u
ications? - √Answer :Less than 7 u u u u u
Quiz :Tx based on A1C - √Answer :Les than 9=metformin
u u u u u u u u u u
Between 9-10 dual oral therapy u u u u u
Above 10=insulin u
Quiz :How long do you wait before starting someone on the
u u u u u u u u u u u
next step of therapy? -
u u u u
√Answer :3 months of therapy where the A1C doesnt drop t
u u u u u u u u u u u
o below 7
u u
Quiz :What is tx goal for patients with essential hypertensio
u u u u u u u u u
n? - √Answer :<130/80
u u u
Quiz :When do you start 1 or 2 drugs? -
u u u u u u u u u
√Answer :start 2 drugs if more than 20/10 increased from th
u u u u u u u u u u u
e goal
u
use one drug in the in between
u u u u u u u
IONS AND ANSWERS (A+) u u u
What disease can hyperthyroidism unmask? -
u u u u u
√Answer :Diabetes
u u
Unmasks glucose intolerance and adversely effects glucos
u u u u u u
e and lipid management
u u u
Quiz :What diseases are associated with T1D? -
u u u u u u u
√Answer :Hashimotos
u u u
Graves u
*autoimmune diseases* u
Quiz :What is a key component of HHS treatment? -
u u u u u u u u u
√Answer :Fluid replacement
u u u u
In many cases several liters
u u u u
Quiz :What is the most common underlying cause of HHS?
u u u u u u u u u u
- √Answer :Decreased fluid intake
u u u u u
UTI
Pneumonia u
MI, stroke and PE can also precipitate it
u u u u u u u
Quiz :Screening for TIID? - √Answer :Normal starts at 45
u u u u u u u u u u
Or
Overweight with one or more risk factors: u u u u u u u
Physical inactivity u u
High risk ethnicity u u u
,First degree relative with diabetes
u u u u
Impaired glucose previously u u u
Stage 2 hypertension (140/90)
u u u
Low HDL and High TG
u u u u
gestational diabetes u
PCOS
CVD HX u u
acanthosis
Quiz :Symptoms of hyperglycemia -
u u u u
√Answer :Unexplained weight loss
u u u u
Polyuria
Quiz :Dx of diabetes - √Answer :A1C: greater than 6.5
u u u u u u u u u u
2 hour postprandial over 200
u u u u u
Fasting over 126 u u
Random over 200 with symptoms of hyperglycemia
u u u u u u
Quiz :What causes vision changes in someone with diabet
u u u u u u u u
es - u
u√Answer :Darks spots: new blood vessels forming and leak
u u u u u u u u
ing u
Blurriness: macular edema u u u
Vision changes are a late complication of diabetic changes.
u
u u u u u u u u
40% of patients requiring insulin develop retinopathy 5 year
u u u u u u u u
s later
u
Quiz :What do retinal hemorrhages look like and what caus
u u u u u u u u u
es them? - √Answer :Dark blots with indistinct borders—
u u u u u u u u
indicate partial obstruction and infarction
u u u u
,Quiz :What are cotton wool spots and what does it mean? -
u u u u u u u u u u u
√Answer :White spots with fuzzy borders
u u u u u u
Previous areas of infarction, usually with hemorrhages
u u u u u u
Quiz :What do microaneurysms look like in the eye? -
u u u u u u u u u
√Answer :Punctuate dark lesions— well circumscribed
u u u u u u
Quiz :What causes neovascularization? -
u u u u
√Answer :Hypoxia and vessel occlusion
u u u u u
Quiz :Parts of a diabetic foot exam -
u u u u u u u
√Answer :Dorsalis pedis and posterior tib pulses
u u u u u u u u
Ankle jerk reflex u u u
Filament testing u u
Skin for hair loss, breaks in skin, bony prominences etc
u u u u u u u u u
Quiz :What labs should be ordered for someone with diabet
u u u u u u u u u
es that hasn't been seen for a year? - √Answer :A1C
u u u u u u u u u u
Lipid panel u
TSH u
Creatine/ GFR u u
B12 levels (metformin Lowers this)
u u u u u
Spot albumin to creatinine ratio (testing for microalbuminuri
u u u u u u u
a)
Quiz :When should moderate intensity statin be administrat
u u u u u u u
ed? - √Answer :Age 40-75 with LDL over 70 and DM
u u u u u u u u u u
Quiz :When to use high intensity statin? -
u u u u u u u
√Answer :Moderate risk plus 7.5% estimated 10 yr CVD ris
u u u u u u u u u u
k
, Quiz :Goal BP for patients with diabetes? -
u u u u u u u
√Answer :Less than 130/80
u u u u u
(That is stage 1 hypertension)
u u u u
Quiz :Does aspirin decrease risk of heart disease in someo
u u u u u u u u u
ne with diabetes and no other CVD risk factors? -
u u u u u u u u u
√Answer :No
u u
**only give them aspirin if they have hex of CVD... aka over
u u u u u u u u u u u u
50 with HTN, HLD, smoking, microalbuminuria and are not
u u u u u u u u u
at an increase risk of bleeding
u u u u u
Quiz :What A1C is known to decrease microvascular compl
u u u u u u u u
ications? - √Answer :Less than 7 u u u u u
Quiz :Tx based on A1C - √Answer :Les than 9=metformin
u u u u u u u u u u
Between 9-10 dual oral therapy u u u u u
Above 10=insulin u
Quiz :How long do you wait before starting someone on the
u u u u u u u u u u u
next step of therapy? -
u u u u
√Answer :3 months of therapy where the A1C doesnt drop t
u u u u u u u u u u u
o below 7
u u
Quiz :What is tx goal for patients with essential hypertensio
u u u u u u u u u
n? - √Answer :<130/80
u u u
Quiz :When do you start 1 or 2 drugs? -
u u u u u u u u u
√Answer :start 2 drugs if more than 20/10 increased from th
u u u u u u u u u u u
e goal
u
use one drug in the in between
u u u u u u u
