Physical Assessment 3

PUD is inflammation (with/without/both) ulceration of (upper/lower) GI mucosa caused by gastric contents

- both - upper (stomach and duodenum)

which conditions are associated with metabolic syndrome (hint: theres 2)

- ischemic heart disease - congestive heart failure

what are the main GI disease signs

1. abdominal tenderness 2. hematemesis 3. jaundice 4. weight loss 5. abnormal stool 6. organomegaly/ascites 7. elevated liver abnormalities, low A/G ratio

what are the 5 main GI disease symptoms

1. nausea 2. gastric reflux 3. abdominal cramps/pain 4. diarrhea 5. bleeding tendency or anemia

plasma glucose is considered elevated at what value

100 mg/dl

what percent of ulcers are due to NSAIDs

15-20%

elevated triglycerides are considered to be greater than or equal to what value?

150mg/dl **patient may also be on meds for lipids

what are the most common causes of death for type 1 and type 2

1: renal failure 2: MI

what percent of the US population has diabetes

9.4%

elevated blood pressure falls in which range?

>130/85

hyperglycemia can lead to

atherosclerotic plaques

what are the major hepatitis lab findings

bilirubin, *alanine aminotransferase* (ALT), aspartate aminotransferase (AST)

what are the main features of malabsorption disease and what are they caused by

debilitation, anemia, vitamin deficiency caused by villi destruction

why would blood tests indicate anemia in a patient with malabsorption/intestinal disease

due to iron, B12, and folate deficiencies

you are 25X more likely to acquire ________ with DM than a healthy individual

end stage renal disease

diabetes mellitus can be categorized as what type of disease

endocrine

features of PUD include:

epigastric pain: received by bland food chronic gastritis: caused by irritants like NSAIDs GERD: assoc with acid taste from reflux

what are the levels of control for HbA1c

excellent < 6.5 marginal 6.5 - 8.5 poor > 8.5

what are the signs of hyperglycemic shock you should look for

fatigue, lassitude dry skin gradual progression

arrange the following into focal and diffuse categories: - polyps - hemorrhoids - ulcerative colitis - diverticulitis - Crohn's disease

focal: polyps, hemorrhoids, and diverticulitis diffuse: ulcerative colitis and Crohns (IBD)

what are the five signs of metabolic syndrome and how many does a patient need to have to be considered to have metabolic syndrome?

need 3/5: 1. abdominal obesity 2. elevated fasting triglycerides 3. hypertension 4. elevated fasting glucose 5. low HDL levels

what are the signs of hypoglycemic shock you should look for

nervousness, unconsciousness, then convulsions moist skin rapid progression

what are fosamax, actonel, and Boniva?

nitrogen-containing drugs assoc with ulcers

what oral effects can DM have

poor wound healing increase incidence and severity of caries, gingivitis and PD

why is hepatitis significant to dentistry

possibility of infectivity medication metabolism changes decreased protein production (coagulation) liver failure

what might you notice about the complexion of a person with alcoholic cirrhosis

red complexion and spider angiomas

what can result from DM1 and small vessel sclerosis

retinopathy, nephropathy, neuropathy, gangrene

in alcoholic cirrhosis, hepatic parenchyma is replaced with _______ due to

scar tissue due to chronic hepatic necrosis

which category of disease do hepatitis and hepatic cirrhosis fall into

GI diseases

which bacteria is present in 80% of peptic ulcers

H pylori

is hyperglycemic or hypoglycemic shock more severe? which is more likely to occur?

Hypoglycemic shock for both

what can result from chronic PUD

anemia, decreased platelets and coagulation factors - perforated ulcers can be life threatening

endocrine diseases main signs are

abnormal weight/proportions goiter skin discoloration acetone breath BP abnormality blood/urine glucose abnormality

severity of DM complications is related to ________

glycemic control

healthy vs well controlled diabetes HbA1c normal values should be less than:

healthy: 6% controlled diabetes: 7%

what are the main symptoms of endocrine diseases

heat/cold intolerance weight changes nervousness personality changes altered urinary frequency

what disease is characterized by icterus, elevated liver enzymes, abnormal A/G ratio, fever and liver enlargement

hepatitis

yellow palate is characteristic of which disease

hepatitis

what value indicates hyperglycemic shock? what about hypo?

hyper: >400mg/dl hypo: <40mg/dl

if DM is not well controlled, what happens:

hyperglycemia/ketoacidosis hypoglycemia small vessel sclerosis delayed wound healing opportunistic infections/ rapid progression of other infections

what is the poly triad

in type 1 DM: - polyuria, polydipsia, polyphagia

what causes inflammatory bowel disease

inability of body to down regulate immune system to control GI inflammation

pain meds _______ (increase/decrease) symptoms of PUD

increase

how can DM 2 be managed

initial: diet and oral meds later: insulin

endocrine diseases have a ________ onset

insidious

how is control defined for DM

maintaining blood glucose within physiologic range (HbA1c)

celiac and pancreatic disease are both types of _________

malabsorption conditions

what is considered low HDL in men and women?

men: <40mg/dl women: <50mg/dl

diabetes mellitus is considered what type of syndrome?

metabolic syndrome

which type of diabetes in insulin-dependent

type 1