Diabetes Mellitus Overview
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Questions and Answers

What is the primary characteristic of diabetes mellitus?

  • Specific microangiopathy affecting the eyes and kidneys
  • Inability to produce and/or use insulin (correct)
  • Persistent hyperglycemia
  • Accelerated onset of nonspecific atherosclerosis
  • What is the most prevalent type of diabetes mellitus?

  • Gestational diabetes
  • Type 2 diabetes (correct)
  • Maturity-onset diabetes of the young (MODY)
  • Type 1 diabetes
  • Which of the following is a specific complication of chronic diabetes?

  • Hyperlipidemia
  • Cardiovascular disease
  • Hypertension
  • Retinopathy and nephropathy (correct)
  • Why is it important for dentists to be aware of diabetes?

    <p>All of the above</p> Signup and view all the answers

    What is the incidence of type 1 diabetes compared to type 2 diabetes in persons younger than 20 years of age?

    <p>Type 1 diabetes is more than four times more prevalent than type 2 diabetes</p> Signup and view all the answers

    What is a key role of dentists in the management of diabetes?

    <p>Rendering care to patients with diabetes without endangering their well-being</p> Signup and view all the answers

    What are the three main goals of therapy for type 1 or type 2 diabetes?

    <p>Eliminate symptoms related to hyperglycemia, reduce or eliminate long-term complications, and allow the patient to achieve a normal lifestyle</p> Signup and view all the answers

    What plasma glucose level is typically associated with the resolution of diabetes symptoms?

    <p>Below 11.1 mmol/L</p> Signup and view all the answers

    What is the role of the physician in managing diabetes?

    <p>To identify a target level of glycemic control, provide the patient with educational and pharmacologic resources, and monitor and treat diabetes-related complications</p> Signup and view all the answers

    Which of the following is NOT a long-term complication of diabetes that the physician aims to reduce or eliminate?

    <p>Gastrointestinal complications</p> Signup and view all the answers

    What is the purpose of providing the patient with educational resources in diabetes management?

    <p>To help the patient reach the target level of glycemic control</p> Signup and view all the answers

    Which of the following is NOT a key aspect of the physician's role in managing diabetes?

    <p>Ensuring the patient maintains a healthy body weight</p> Signup and view all the answers

    What is the purpose of monitoring and treating diabetes-related complications in the management of diabetes?

    <p>To reduce or eliminate the long-term microvascular and macrovascular complications of diabetes</p> Signup and view all the answers

    What is the main concern when providing postoperative analgesics for long-term steroid users?

    <p>Peptic ulceration</p> Signup and view all the answers

    When managing dental patients taking steroids, what concern arises regarding adrenal crisis during and after surgery?

    <p>Hypotension</p> Signup and view all the answers

    In dental patients undergoing invasive procedures with a history of hyperadrenalism, when should these procedures ideally be performed?

    <p>During periods of good glucose control</p> Signup and view all the answers

    What did Fraser and colleagues report in 1952 regarding cortisone use and surgery?

    <p>Hypotension leading to death post-surgery</p> Signup and view all the answers

    What is the primary reason for arranging follow-up appointments for dental patients with hyperadrenalism?

    <p>To assess proper wound healing</p> Signup and view all the answers

    Which of the following is a significant concern for patients on long-term steroids undergoing dental procedures?

    <p>Osteoporosis</p> Signup and view all the answers

    What is the main reason behind the concern of providing certain analgesics to long-term steroid users post-surgery?

    <p>Potential for peptic ulceration</p> Signup and view all the answers

    Why might additional corticosteroids be necessary for patients on regular steroid regimens during and after dental surgery?

    <p>To prevent adrenal crisis</p> Signup and view all the answers

    What is the primary consideration for dental management of patients taking corticosteroids?

    <p>Assessing the type of corticosteroid insufficiency</p> Signup and view all the answers

    Which of the following medications should be discontinued at least 24 hours before surgery for a patient taking corticosteroids?

    <p>Phenytoin</p> Signup and view all the answers

    What is the immediate treatment required during an adrenal crisis in a patient taking corticosteroids?

    <p>Administer 100 mg of hydrocortisone or 4 mg of dexamethasone IV and provide fluid replacement</p> Signup and view all the answers

    Why is it important for dentists to avoid the use of phenobarbital in patients taking corticosteroids?

    <p>Phenobarbital increases the metabolism of cortisol and reduces blood levels of cortisol</p> Signup and view all the answers

    What is the primary goal of monitoring blood pressure in patients taking corticosteroids during dental procedures?

    <p>To prevent adrenal crisis</p> Signup and view all the answers

    Which of the following is a key consideration for dentists when managing patients taking corticosteroids?

    <p>Evaluating the patient's risk of developing adrenal crisis</p> Signup and view all the answers

    Which of the following medications should be discontinued at least 24 hours before surgery for a patient taking corticosteroids?

    <p>Ketoconazole</p> Signup and view all the answers

    What is the primary reason for dentists to be aware of a patient's corticosteroid use?

    <p>To provide appropriate supplemental steroids during stress or illness</p> Signup and view all the answers

    Which product in excess leads to mineralocorticoid excess (primary aldosteronism)?

    <p>Aldosterone</p> Signup and view all the answers

    What is the most common form of hyperadrenalism that leads to Cushing syndrome?

    <p>Glucocorticoid excess</p> Signup and view all the answers

    Which physical characteristic is NOT typically associated with Cushing syndrome?

    <p>Dependent edema</p> Signup and view all the answers

    Hypotension, dehydration, and shock are seldom encountered in which type of adrenal crisis?

    <p>Tertiary adrenal suppression</p> Signup and view all the answers

    Which of the following is NOT a syndrome produced by adrenal hyperfunction?

    <p>Renin secretion</p> Signup and view all the answers

    What is the main cause of Cushing syndrome?

    <p>Glucocorticoid excess</p> Signup and view all the answers

    Which of the following is NOT a symptom of mineralocorticoid excess (primary aldosteronism)?

    <p>'Moon facies'</p> Signup and view all the answers

    'Moon facies' is a characteristic physical feature associated with which disorder?

    <p>'Moonitis'</p> Signup and view all the answers

    What is the primary function of the adrenal medulla?

    <p>Secretion of epinephrine</p> Signup and view all the answers

    What is the primary role of cortisol in the body?

    <p>Regulation of blood sugar levels</p> Signup and view all the answers

    What is the effect of cortisol on the inflammatory response?

    <p>Cortisol inhibits inflammation through its actions on lysosome release, prostaglandin production, and adhesion molecules</p> Signup and view all the answers

    What is the normal daily secretion rate of cortisol?

    <p>20 mg</p> Signup and view all the answers

    What is the effect of stress on cortisol secretion?

    <p>Stress increases cortisol secretion through stimulation of the HPA axis</p> Signup and view all the answers

    What is the primary function of the adrenal cortex?

    <p>Secretion of steroid hormones</p> Signup and view all the answers

    What is the term used to describe excessive secretion of adrenal hormones?

    <p>Hyperadrenalism</p> Signup and view all the answers

    What is the typical pattern of cortisol secretion over a 24-hour period?

    <p>Cortisol levels are highest in the morning and lowest in the evening</p> Signup and view all the answers

    What is the expected number of patients with potential adrenal abnormalities or using corticosteroids in a dental practice serving 2000 adults?

    <p>50 patients</p> Signup and view all the answers

    Which condition is characterized by the destruction or removal of the adrenal cortex?

    <p>Primary adrenocortical insufficiency (Addison disease)</p> Signup and view all the answers

    What is the cause of tertiary adrenal insufficiency?

    <p>Processes that impair hypothalamic function, often chronic corticosteroid use</p> Signup and view all the answers

    What is the term used to describe the generalized state caused by excessive cortisol in the body, regardless of the cause?

    <p>Cushing syndrome</p> Signup and view all the answers

    What condition can occur if a patient with adrenal insufficiency does not have adequate circulating cortisol during times of stress?

    <p>Adrenal crisis</p> Signup and view all the answers

    Which type of adrenocortical insufficiency is a consequence of pituitary disease or lack of adrenal responsiveness to ACTH?

    <p>Secondary adrenocortical insufficiency</p> Signup and view all the answers

    What is the most common cause of overproduction of glucocorticoids?

    <p>Cushing disease</p> Signup and view all the answers

    Which statement about the signs and symptoms of hypoadrenalism (adrenocortical hormone deficiencies) is true?

    <p>They are often nonspecific, unless the patient is significantly stressed</p> Signup and view all the answers

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