Anesthesia Pharmacology: Diabetes Clinical Presentations and Management

Second generation sulfonylurea antidiabetic drug:
1. Chlorpropamide (Diabinese)
2. Tolbutamide (Orinase)
3. Glipizide (Glucotrol)
4. A & C
5. A, B & C
Clinically use(s) for glucagon:
1. management of severe hyperglycemia
2. beta adrenergic receptor poisoning
3. diagnostic uses
4. B & C
5. A & C
Major manifestations of diabetes:
1. metabolic disorders
2. inappropriate hyperglycemia
3. both
4. neither
Insulin-dependent diabetes mellitus:
1. Type I
2. Type II
Characteristics of Type I diabetes:
1. typically adult onset
2. low plasma glucagon
3. insulin nearly absent
4. pancreatic B cell is responsive to insulinogenic stimuli
In a patient with Type I diabetes, exogenous insulin is required to:
1. prevent ketosis
2. reverse hypoglucagonemia
3. reverses catabolic state
4. A & C
5. A, B & C
Symptoms Secondary to Hyperglycemia in a Type I Diabetic Patient
1. polyuria
2. polydipsia
3. polyphagia
4. A, B & C
5. none of the above
Cause(s) of metabolic effecct(s) associated with Type I diabetes:
1. relative or significant glucagon excess
2. an increase in glucagon/insulin ratio
3. excessive insulin concentration
4. A & B
5. A, B & C
IDDM: typical age of onset
1. less than 40 years of age
2. greater than 40 years of age
Acute complication: NIDDM
1. ketoacidosis
2. hyperosmolar coma
Plasma insulin concentration: NIDDM
1. low to absent
2. normal to high
IDDM: response to sulfonylurea drugs:
1. unresponsive
2. responsive
Characteristic(s)of Type II diabetes:
1. Group of milder forms of diabetes
2. Occurs mainly in children
3. Obesity: common risk factor
4. A & C
5. A, B & C
Clinical presentation: NIDDM
1. usually developed ketoacidosis
2. exhibits volume excess
3. CNS symptoms
4. exhibits hypo-osmolality
Hyperosmolar, nonketotic coma:
1. caused by sustained hyperglycemia diuresis when patients cannot drink enough water to keep up with urinary fluid loss
2. complete manifestation occurs when volume depletion decreases urine output
3. both
4. neither
Treatment of hyperosmolar coma states
1. large amounts of IV fluids
2. insulin
3. potassium salts
4. sodium bicarbonate
5. all the above
Type II diabetes treatment --
1. weight reduction
2. diet
3. insulin
4. sulfonylurea drugs
5. all the both
Clinical use for short-acting insulin
1. IV treatment for diabetic ketoacidosis
2. management of rapidly changing insulin requirements
3. both
4. neither
Tight glycemic control recommended:
1. for patients with advance renal disease
2. elderly
3. children under the age of seven years
4. none of the above
Most common complication of insulin treatment
1. excessive appetite
2. tachycardia, palpitations -- sympathetic overactivity
3. hypoglycemia