This is a sample of our (approximately) 6 page long Diabetes notes, which we sell as part of the Endocrinology Notes collection, a MBChB (hons) (1st) package written at University Of Leicester in 2014 that contains (approximately) 28 pages of notes across 7 different documents.
The original file is a 'Word (Docx)' whilst this sample is a 'PDF' representation of said file. This means that the formatting here may have errors. The original document you'll receive on purchase should have more polished formatting.
The following is a plain text extract of the PDF sample above, taken from our Endocrinology Notes. This text version has had its formatting removed so pay attention to its contents alone rather than its presentation. The version you download will have its original formatting intact and so will be much prettier to look at.
Diabetes Type 1 Diabetes Epidemiology
- Can occur at any age, usually juvenile onset (13 years) Aetiology
- Genetic predisposition (HLA DR3 + HLA DR4) + environmental trigger (? Viral) Pathophysiology
- Autoimmune destruction of Beta cells of Islet of Langerhan (pancreas)
- Complete insulin deficiency Excess urine production due to osmotic effects of high blood Clinical features glucose retaining water in
- Classic triad o Polydypsia Excess water loss + osmotic o Polyuria effects of high glucose =
o Weight loss effects on thirst centres Lipolysis + proteolysis due to glucose not getting to tissues (ketone production) May present in DKA Fatigue Investigations
- Hx + postitive test or 2 positive tests on separate occasions o Fasting plasma glucose ≥ 7.0mmol/L o Random blood glucose ≥ 11.0 mmol/L o Oral glucose tolerance test ≥ 11.0 mmol/L (75g in 300ml water)
- Urine dip for glycosuria
Increase BMs Increase insulin if glucose is higher Admit if patient is vomiting, dehydrated or ketotic
Diabetic Ketoacidosis (DKA) Lipolysis Free fatty acids Ketoacidosis (low pH)
- Sluggish, extreme tiredness, extreme thirst, constant urination, fruity smell to breath (ketotic breath), hyperventilation, nausea, vomiting, abdominal pain, coma Precipitants
- Wrong insulin dose For diagnosis need ketosis + acidosis Investigations
- Bloods o Glucose o U+E (risk of hypokalaemia with treatment of DKA, hyperkalaemia without) o Amylase (pancreatitis often present) o FBC (infection screen, WCC, platelets) o ABG (acidosis) o Cultures (infection screen)
- Imaging o CXR (Infection)
- Urinalysis (ketones)
- ECG (hyperkalaemia) Management
- Iv access
- Fluids (resuscitation with saline - boluses)
- Check plasma glucose
- NG tube if vomiting or unconscious
- Start insulin sliding scale
- Treat underlying cause
- K+ replacement +/- phosphate replacement Complications
- Cerebral oedema
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