Diabetes mellitus: Clinical (To be retired)
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Diabetes mellitus: Clinical (To be retired)
Medicine and surgery
Allergy and immunology
Antihistamines for allergies
Glucocorticoids
Cardiology, cardiac surgery and vascular surgery
Coronary artery disease: Clinical (To be retired)
Heart failure: Clinical (To be retired)
Syncope: Clinical (To be retired)
Hypertension: Clinical (To be retired)
Hypercholesterolemia: Clinical (To be retired)
Peripheral vascular disease: Clinical (To be retired)
Leg ulcers: Clinical (To be retired)
Adrenergic antagonists: Alpha blockers
Adrenergic antagonists: Beta blockers
ACE inhibitors, ARBs and direct renin inhibitors
Thiazide and thiazide-like diuretics
Calcium channel blockers
Lipid-lowering medications: Statins
Lipid-lowering medications: Fibrates
Miscellaneous lipid-lowering medications
Antiplatelet medications
Dermatology and plastic surgery
Hypersensitivity skin reactions: Clinical (To be retired)
Eczematous rashes: Clinical (To be retired)
Papulosquamous skin disorders: Clinical (To be retired)
Alopecia: Clinical (To be retired)
Hypopigmentation skin disorders: Clinical (To be retired)
Benign hyperpigmented skin lesions: Clinical (To be retired)
Skin cancer: Clinical (To be retired)
Endocrinology and ENT (Otolaryngology)
Diabetes mellitus: Clinical (To be retired)
Hyperthyroidism: Clinical (To be retired)
Hypothyroidism and thyroiditis: Clinical (To be retired)
Dizziness and vertigo: Clinical (To be retired)
Hyperthyroidism medications
Hypothyroidism medications
Insulins
Hypoglycemics: Insulin secretagogues
Miscellaneous hypoglycemics
Gastroenterology and general surgery
Gastroesophageal reflux disease (GERD): Clinical (To be retired)
Peptic ulcers and stomach cancer: Clinical (To be retired)
Diarrhea: Clinical (To be retired)
Malabsorption: Clinical (To be retired)
Colorectal cancer: Clinical (To be retired)
Diverticular disease: Clinical (To be retired)
Anal conditions: Clinical (To be retired)
Cirrhosis: Clinical (To be retired)
Breast cancer: Clinical (To be retired)
Laxatives and cathartics
Antidiarrheals
Acid reducing medications
Hematology and oncology
Anemia: Clinical (To be retired)
Anticoagulants: Warfarin
Anticoagulants: Direct factor inhibitors
Antiplatelet medications
Infectious diseases
Pneumonia: Clinical (To be retired)
Urinary tract infections: Clinical (To be retired)
Skin and soft tissue infections: Clinical (To be retired)
Protein synthesis inhibitors: Aminoglycosides
Antimetabolites: Sulfonamides and trimethoprim
Miscellaneous cell wall synthesis inhibitors
Protein synthesis inhibitors: Tetracyclines
Cell wall synthesis inhibitors: Penicillins
Miscellaneous protein synthesis inhibitors
Cell wall synthesis inhibitors: Cephalosporins
DNA synthesis inhibitors: Metronidazole
DNA synthesis inhibitors: Fluoroquinolones
Herpesvirus medications
Azoles
Echinocandins
Miscellaneous antifungal medications
Anti-mite and louse medications
Nephrology and urology
Chronic kidney disease: Clinical (To be retired)
Kidney stones: Clinical (To be retired)
Urinary incontinence: Pathology review
ACE inhibitors, ARBs and direct renin inhibitors
PDE5 inhibitors
Adrenergic antagonists: Alpha blockers
Neurology and neurosurgery
Stroke: Clinical (To be retired)
Lower back pain: Clinical (To be retired)
Headaches: Clinical (To be retired)
Migraine medications
Pulmonology and thoracic surgery
Asthma: Clinical (To be retired)
Chronic obstructive pulmonary disease (COPD): Clinical (To be retired)
Lung cancer: Clinical (To be retired)
Antihistamines for allergies
Bronchodilators: Beta 2-agonists and muscarinic antagonists
Bronchodilators: Leukotriene antagonists and methylxanthines
Pulmonary corticosteroids and mast cell inhibitors
Rheumatology and orthopedic surgery
Joint pain: Clinical (To be retired)
Rheumatoid arthritis: Clinical (To be retired)
Lower back pain: Clinical (To be retired)
Anatomy clinical correlates: Clavicle and shoulder
Anatomy clinical correlates: Arm, elbow and forearm
Anatomy clinical correlates: Wrist and hand
Anatomy clinical correlates: Median, ulnar and radial nerves
Anatomy clinical correlates: Bones, joints and muscles of the back
Anatomy clinical correlates: Hip, gluteal region and thigh
Anatomy clinical correlates: Knee
Anatomy clinical correlates: Leg and ankle
Anatomy clinical correlates: Foot
Acetaminophen (Paracetamol)
Non-steroidal anti-inflammatory drugs
Glucocorticoids
Opioid agonists, mixed agonist-antagonists and partial agonists
Antigout medications
Non-biologic disease modifying anti-rheumatic drugs (DMARDs)
Osteoporosis medications
Assessments
Diabetes mellitus: Clinical (To be retired)
USMLE® Step 2 questions
0 / 31 complete
Questions
USMLE® Step 2 style questions USMLE
of complete
| Laboratory value | Result |
| White blood cells | 28,000 /mm3 |
| Creatinine | 2.3 mg/dL |
| Glucose | 374 mg/dL |
| Bicarbonate | 19 mEq/L |
| Ketones | Positive |
Reproduced from: Wikimedia Commons
Which of the following antimicrobial agents is most appropriate to administer to this patient?
Memory Anchors and Partner Content
Transcript
Content Reviewers
Rishi Desai, MD, MPHContributors
Marisa Pedron
Evan Debevec-McKenney
In diabetes mellitus, the body has trouble moving glucose from your blood into the cells – so blood sugar levels are constantly high. Insulin stimulates the movement of glucose into the cells, and glucagon stimulates the movement of glucose into the blood. In type I diabetes the blood glucose stays high because of an autoimmune destruction of the pancreas, which leads to low insulin levels. In type II diabetes, the body makes insulin, but the cells are insulin resistant - meaning they don’t “respond” to insulin by taking glucose in.
Cells’ inability to use insulin translates in classical symptoms of diabetes like polyuria – individuals pee a lot -, polydipsia – they drink a lot of water -, sometimes polyphagia – they eat a lot – and unexplained weight loss. Both type I and type II diabetes get these symptoms – however, with type I, the onset is usually abrupt and usually affects people under 30. With type II, the symptoms gradually worsen over a few months, and individuals usually have risk factors like being over 45 years old, having a first degree relative with type II diabetes mellitus, a body mass index (BMI) over 25, a sedentary lifestyle, or cardiovascular disease, like hypertension.
Now, type II diabetes accounts for about 90% of the diabetes cases, so let’s start there. Diagnosing type II diabetes relies on determining blood sugar levels using one of four tests. The first, and most common test, is a fasting glucose test and it’s where the person doesn’t eat or drink anything except water for 8 hours. Levels of 100 milligrams per deciliter to 125 milligrams per deciliter indicates prediabetes and a level of 126 milligrams per deciliter or higher indicates diabetes. Usually this test is done twice, and two results over 126 milligrams per deciliter are sufficient to diagnose a person with diabetes. Second, we have the oral glucose tolerance test, and it’s where a person is given 75 grams of glucose, and then blood samples are taken at time intervals to figure out how well it’s being cleared from the blood. At the time interval of 2 hours later, a level of 140 milligrams per deciliter to 199 milligrams per deciliter indicates prediabetes, and a level of 200 or above indicates diabetes. However, these two tests have one shortcoming - they only show what’s happening to blood glucose levels in that particular moment in time, so we have no idea how long blood sugar levels have been high. This is where our third test comes in - the HbA1c, which is the proportion of glycated hemoglobin in the blood. When blood glucose levels stay high for too long, glucose begins to stick to proteins that are floating around in the blood or in cells - like hemoglobin. HbA1c levels of 5.7% to 6.4% indicate prediabetes, and 6.5% or higher indicates diabetes. Since red blood cells - and hemoglobin - typically hang around in the blood for up to 4 months, this test reflects blood glucose levels over the past few months. Finally, there’s our fourth test, called a non-fasting or random glucose test, which can be done at any time. A red flag for diabetes is when this test shows a blood glucose level of 200 milligrams per deciliter or higher in an individual that has classic symptoms, like polyuria or polydipsia; or a hyperglycemic crisis.
Summary
Diabetes mellitus is a metabolic condition characterized by high blood sugar levels (glycemia). The two types of diabetes mellitus are type 1 and type 2. Type 1 Diabetes Mellitus, also called insulin-dependent diabetes, usually begins in childhood or adolescence. In this form of the disease, an autoimmune process triggers the destruction of pancreatic beta cells responsible for producing insulin, and thus the body produces little or no insulin. Insulin is a hormone that helps the body to use sugar for energy.
Type 2 diabetes mellitus, also called non-insulin-dependent diabetes, usually begins in adulthood. In this type, the body produces insulin but becomes resistant to it, meaning it cannot use it effectively. Type 2 diabetes mellitus has a genetic component, and a sedentary lifestyle and obesity significantly elevate its risk.
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