Science Medicine
FNP - 4
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Dermatology APEA: Endocrinology Chapter 11 Book Rev
69 terms 52 terms 11 terms
alexarharris Preview sdraulis Preview gracie_langsdorf
when to start screening for every adult - starting at age 45 - then every 3 years if normal - if
diabetes BMI ≥ 25 and on or more risk factors for DM - screen annually
age ≥ 45, BMI ≥ 25, family hx, habitual physical activity, HTN
(140/90 or >), HDL ≤ 35 and/or trigs ≥ 250, PCOS, history of
DM risk factors vascular disease, delivery of macrocosmic infant, AA, hispanic,
native american, asian-american, pacific islanders, previously
identified A1C ≥ 5.7% or higher (impaired fasting glucose)
1) A1C ≥ 6.5%; 2) FPG ≥ 126 (fasting for 8 hours); 3) 2 hour plasma
glucose > 200 during an OGTT; 4) random glucose ≥ 200 with sx
Diagnostic criteria for DM
(means dx on the spot) - criteria 1-3 should be confirmed by
repeat testing unless hyperglycemia is unequivocal
BG 100-125 - must be confirmed on subsequent day (this is pre
impaired fasting glucose diabetes); 2 hour post prandial glucose of 140-199 after the
OGTT; A1C of 5.7 - 6.4%
reduces A1C by 1-2% - top choice for oral tx unless
metformin reduces CV risks!!
contraindication
what is the mechanism of action reduces hepatic glucose production and enhances action of
of metformin insulin
metformin reduces all cause ...
mortality
what are the 2 most common diarrhea and flatulence
side effects of metformin
what should blood sugar be 1-2 < 180 - know!
hours after eating
what should AM fasting target 70 - 130 - know!
be
annual foot exam for diabetics every visit
unless PAD or neuropathy and
then do
, how often to do dilated eye annually at onset of type 2 DM - after 5 years of dx if type 1
exam in diabetics
how often to do dental exam in annually (periodontal dz is more severe in patients with DM)
diabetics
how often to do fasting lipid annually
profile in diabetics
how often to do A1C in diabetics every 3-6 months (goal is < 7%)
how often to do urinary albumin annually (and 3-5 years after dx of type 1)
to creatinine ratio in diabetics
how often to do serum initially and then as indicated depending on renal status
creatinine in diabetics
risks and sx of eye issues with microaneurysms, red dots - can leak and reduce vision;
diabetics hemorrhages, fatty exudates
when you see ancanthosis insulin resistance
nigricans, always think
what class is metformin biguanide
what are some examples of glimepiride, glipizide, glyburide
sulfonyureas
diabetic drugs ending in gliptins Dpp-4 inhibitors - januvia (sitagliptin) - no generics available so
are not for use with fixed budget pts
2 most common side effects of hypoglycemia, weight gain
sulfonyureas
sulfonyureas are very cheap so if patient is on fixed budget and can take it, it is a good choice
GLP-1 diabetic meds are sub Q (Byetta, victoza) - increase production of insulin - help
administered with wt loss
TZDs for diabetes (ploglitazone, black box warning - contraindicated with heart failure
rosiglitazone)
when fasting glucose is ≥ 250; when A1C > 10%; after maxing out
when should you consider
orals; is sx of hyperglycemia; pregnant patients; consider it
insulin as initial choice
EARLY!
what BG value should be used AM fasting
to determine need for long-
acting insulin
either 10 units once daily - OR 0.2 units/kg/day once daily - start
KNOW dosing for basal insulin
with bolus dose at bed time
when to increase basal insulin if AM FBG > 130, then add 2-3 units per day until fasting glucose
and by how much is at goal
what measurement helps to free T4
confirm abnormal TSH
fatigue is common in both hyper In hyper, it's cuz they can't slow down
and hypothyroidism
metabolic abnormalities seen hyperlipidemia, macrocytic anemia
with hypothyroidism
start with TSH test only ...
normal TSH value 0.5 - 4.5
FNP - 4
Save
Students also studied
Flashcard sets Study guides
Dermatology APEA: Endocrinology Chapter 11 Book Rev
69 terms 52 terms 11 terms
alexarharris Preview sdraulis Preview gracie_langsdorf
when to start screening for every adult - starting at age 45 - then every 3 years if normal - if
diabetes BMI ≥ 25 and on or more risk factors for DM - screen annually
age ≥ 45, BMI ≥ 25, family hx, habitual physical activity, HTN
(140/90 or >), HDL ≤ 35 and/or trigs ≥ 250, PCOS, history of
DM risk factors vascular disease, delivery of macrocosmic infant, AA, hispanic,
native american, asian-american, pacific islanders, previously
identified A1C ≥ 5.7% or higher (impaired fasting glucose)
1) A1C ≥ 6.5%; 2) FPG ≥ 126 (fasting for 8 hours); 3) 2 hour plasma
glucose > 200 during an OGTT; 4) random glucose ≥ 200 with sx
Diagnostic criteria for DM
(means dx on the spot) - criteria 1-3 should be confirmed by
repeat testing unless hyperglycemia is unequivocal
BG 100-125 - must be confirmed on subsequent day (this is pre
impaired fasting glucose diabetes); 2 hour post prandial glucose of 140-199 after the
OGTT; A1C of 5.7 - 6.4%
reduces A1C by 1-2% - top choice for oral tx unless
metformin reduces CV risks!!
contraindication
what is the mechanism of action reduces hepatic glucose production and enhances action of
of metformin insulin
metformin reduces all cause ...
mortality
what are the 2 most common diarrhea and flatulence
side effects of metformin
what should blood sugar be 1-2 < 180 - know!
hours after eating
what should AM fasting target 70 - 130 - know!
be
annual foot exam for diabetics every visit
unless PAD or neuropathy and
then do
, how often to do dilated eye annually at onset of type 2 DM - after 5 years of dx if type 1
exam in diabetics
how often to do dental exam in annually (periodontal dz is more severe in patients with DM)
diabetics
how often to do fasting lipid annually
profile in diabetics
how often to do A1C in diabetics every 3-6 months (goal is < 7%)
how often to do urinary albumin annually (and 3-5 years after dx of type 1)
to creatinine ratio in diabetics
how often to do serum initially and then as indicated depending on renal status
creatinine in diabetics
risks and sx of eye issues with microaneurysms, red dots - can leak and reduce vision;
diabetics hemorrhages, fatty exudates
when you see ancanthosis insulin resistance
nigricans, always think
what class is metformin biguanide
what are some examples of glimepiride, glipizide, glyburide
sulfonyureas
diabetic drugs ending in gliptins Dpp-4 inhibitors - januvia (sitagliptin) - no generics available so
are not for use with fixed budget pts
2 most common side effects of hypoglycemia, weight gain
sulfonyureas
sulfonyureas are very cheap so if patient is on fixed budget and can take it, it is a good choice
GLP-1 diabetic meds are sub Q (Byetta, victoza) - increase production of insulin - help
administered with wt loss
TZDs for diabetes (ploglitazone, black box warning - contraindicated with heart failure
rosiglitazone)
when fasting glucose is ≥ 250; when A1C > 10%; after maxing out
when should you consider
orals; is sx of hyperglycemia; pregnant patients; consider it
insulin as initial choice
EARLY!
what BG value should be used AM fasting
to determine need for long-
acting insulin
either 10 units once daily - OR 0.2 units/kg/day once daily - start
KNOW dosing for basal insulin
with bolus dose at bed time
when to increase basal insulin if AM FBG > 130, then add 2-3 units per day until fasting glucose
and by how much is at goal
what measurement helps to free T4
confirm abnormal TSH
fatigue is common in both hyper In hyper, it's cuz they can't slow down
and hypothyroidism
metabolic abnormalities seen hyperlipidemia, macrocytic anemia
with hypothyroidism
start with TSH test only ...
normal TSH value 0.5 - 4.5
