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Diabetes and Hypertension Complications
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Diabetes and Hypertension Complications
Diabetes and Hypertension Complications
Study
1
Question
What is the overall theme of the initial image?
Answer
Acute and chronic complications of diabetes and hypertension.
2
Question
List the six objectives presented in the second image.
Answer
Chronic complications of diabetes mellitus, Acute metabolic complications (hypoglycemia/diabetic ketoacidosis), Fundus examination, Foot examination, Hypertensive urgency vs emergency, Chronic complications of arterial hypertension
3
Question
What is the title of the image with the abstract graphic?
Answer
Complicaciones metabólicas agudas: hipoglicemia / cetoacidosis diabética
4
Question
List two characteristics of 'Clínica Cetoacidosis diabética'.
Answer
Hiperglicemia + cetoacidosis. Poliuria, polidipsia, pérdida de peso, Aliento dulce, Mareo, letargia, Náusea, Anorexia
5
Question
What are some of the 'Factores precipitantes' of Cetoacidosis diabética?
Answer
Infecciones, mal control glucémico, enf. Agudas (IAM, EVC, sepsis), debut DM1, fármacos que alteran el metabolismo de carbohidratos, inhibidores de SGLT2, cocaína
6
Question
What conditions lead to Diabetic ketoacidosis?
Answer
Deficit absoluto de insulina y/o estrés, infección, tratamiento insulínico insuficiente
7
Question
What hormones increase during diabetic ketoacidosis?
Answer
Glucagón, cortisol, catecholamines, growth hormone
8
Question
List the 'Complicaciones metabólicas'.
Answer
Cetoacidosis diabética, hipoglucemia, estado hiperglucémico hiperosmolar.
9
Question
List the key characteristics of Cetoacidosis Diabética (CAD).
Answer
Hiperglicemia, acidosis metabólica y cetosis.
10
Question
List some of the precipitating factors of CAD.
Answer
Nuevo inicio, omisión de insulina, infección, IAM, estrés fisiológico.
11
Question
List the complications of untreated CAD.
Answer
Hipercalemia, shock, LA, rabdomiólisis
12
Question
What is the initial assessment for Cetoacidosis Diabética (CAD)?
Answer
Test inicial (glucosa, cetonas, ES, GASA / GASV, BUN, Cr, BH), anión GAP y corrección de NA, uroanálisis, ECG.
13
Question
What are the goals in managing Cetoacidosis Diabética (CAD)?
Answer
Restaurar volumen intravascular, prevenir o corregir anormalidades ES, corregir acidosis e hiperglucemia.
14
Question
How is HCO3 administered according to ADA guidelines when managing CAD?
Answer
ADA pH <6.9: 100 mEq en 400 ml H2O estéril + 20 mEq KCl x 2 horas → Cada 2 horas.
15
Question
When should ketone levels be checked, according to the graphic on page 10?
Answer
Con una glucosa arriba de 240mg/dl y/o sintomas, revisa tus niveles de cetonas en sangre (recomendado) u orina.
16
Question
How is insulin administered to patients with Cetoacidosis Diabética (CAD)?
Answer
Administración de insulina, Insulina subcutánea en pacientes alertas que toleren la VO, pH >7, bicarbonato ≥ 10 mEq/L. Insulina basal en pacientes de reciente dx o con quienes ya usaban esta insulina.
17
Question
According to the graphic, what steps should you take if you have positive ketones?
Answer
Contacta a tu médico, Corrige la hiperglucemia, No hagas ejercicio, Revisa cada hora tu nivel de cetonas, Toma agua y electrolitos.
18
Question
List some of the causes of hypoglycemia
Answer
Exceso de dosis de insulina, mal apego al tx VO, alteraciones de la absorción, disminución de carbs, aumento de ejercicio, alcohol, IH o IR. Hipoglucemias de repetición → Hypoglycemia unawareness. Severa causa cardiovasculares o EVC → Accidentes de tráfico. Glucosa < 120 mg/dl antes del ejercicio aeróbico.
19
Question
Symptoms of Level 1 (Mild) Hypoglycemia (≤ 70 mg/dl ≥ 54 mg/dl)
Answer
Anxiety, restlessness, tachycardia, palpitations, tremors, sweating, poor concentration, dizziness, hunger, blurred vision
20
Question
Symptoms of Level 2 (Moderate) Hypoglycemia (< 54 mg/dl)
Answer
Deterioration of neurological state, motor function, inadequate behavior, alert for self-treatment
21
Question
Symptoms of Level 3 (Severe) Hypoglycemia (< 40 mg/dl)
Answer
Coma or convulsive crisis
22
Question
Treatment for Hypoglycemia
Answer
If conscious: Rule of 15 (15-20g of glucose VO, check in 15 minutes, repeat if needed, CHO of rapid absorption 10g, food). If unconscious: Parenteral glucose or glucagon IV or rectal, boluses of glucose of 25g IV.
23
Question
What examinations are important for chronic DM complications?
Answer
Fundus examination, foot examination (micro/macrovascular/neuropathy)
24
Question
What is Diabetic Retinopathy?
Answer
A chronic progressive disease associated with prolonged hyperglycemia, characterized by microangiopathy at the retinal level.
25
Question
What other microvascular complication is commonly associated with diabetic retinopathy?
Answer
Nephropathy
26
Question
Is diabetic retinopathy more frequent and severe in DM type 1 or type 2?
Answer
Diabetes Mellitus Type 1
27
Question
What is the epidemiological importance of diabetic retinopathy concerning blindness?
Answer
It is the most frequent cause of irreversible blindness in the working age population.
28
Question
What is the prevalence of diabetic retinopathy in Mexico?
Answer
Approximately 31.5%
29
Question
What are the risk factors for diabetic retinopathy?
Answer
Mal control of diabetes mellitus, gestation, anemia, hyperlipidemia, HTA, poor metabolic control, dyslipidemia, smoking
30
Question
What are the key structures in a normal retina?
Answer
FOVEA, MÁCULA, DISCO ÓPTICO (optic disc), VENA CENTRAL DE LA RETINA (central retinal vein), ARTERIA CENTRAL DE LA RETINA (central retinal artery), VÉNULAS RETINIANAS (retinal venules), and ARTERIOLAS RETINIANAS (retinal arterioles)