AH1 EXAM 3 | Concepts & Exemplars Med-Surg Exam 3

A comprehensive vocabulary set covering glucose regulation, inflammation, and infection exemplars for Med-Surg Exam 3.

Insulin

A hormone that moves glucose into body cells, promotes storage of glycogen, fat, and protein, and suppresses hepatic glucose output and ketone production.

Glucagon

The primary counterregulatory hormone that protects against hypoglycemia by stimulating hepatic glycogenolysis and gluconeogenesis.

Glycogenesis

The physiological process promoted by insulin that converts glucose to glycogen for storage.

Glycogenolysis

The process of breaking down stored glycogen into glucose to raise blood glucose levels during periods of fasting.

Gluconeogenesis

The creation of glucose from amino acids and other noncarbohydrate sources, which increases when insulin is inadequate.

$$A1C$$

A diagnostic test reflecting average blood glucose over approximately 3 months; values $\ge 6.5\%$ are diagnostic for diabetes.

Hypoglycemia

A blood glucose level below $70\,mg/dL$; it is considered an immediate neurologic emergency because the brain requires circulating glucose.

Hypoglycemia Unawareness

A condition common in older adults or patients with autonomic neuropathy where new confusion or unsteadiness may be the only signs of low blood glucose.

Rule of 15

The treatment for hypoglycemia in alert patients: give $15\,g$ of rapid-acting carbohydrate, recheck glucose in $15$ minutes, and repeat if glucose is still below $70\,mg/dL$.

Type 2 Diabetes Mellitus

A progressive disorder usually beginning with insulin resistance followed by declining pancreatic beta-cell function and relative insulin deficiency.

Acanthosis nigricans

A skin finding that may suggest the presence of insulin resistance in patients with type 2 diabetes.

Autonomic Neuropathy

A chronic complication of diabetes that can lead to orthostatic hypotension, gastroparesis, and painless myocardial infarction.

Rapid-acting Insulin

Insulin types like lispro, aspart, or glulisine with an onset of $10-30$ minutes and peak of $1-3$ hours; highest hypoglycemia risk is near the peak.

Regular Insulin

Short-acting insulin commonly administered IV for the treatment of diabetic crises; onset is $30-60$ minutes.

Basal Insulin

Long-acting insulin (glargine, detemir, degludec) that provide coverage with minimal or no peak; essential for type 1 diabetics even when NPO.

Metformin

A biguanide medication that decreases hepatic glucose production and improves insulin sensitivity; must monitor kidney function for lactic acidosis risk.

Sulfonylureas

Medications like glipizide that stimulate pancreatic insulin release; they carry a high risk for hypoglycemia and weight gain.

Diabetic Ketoacidosis (DKA)

A condition resulting from severe insulin deficiency characterized by hyperglycemia, ketones, and an anion-gap metabolic acidosis.

Kussmaul respirations

Deep, rapid respirations observed in DKA as the body attempts to compensate for metabolic acidosis.

Hyperglycemic-Hyperosmolar State (HHS)

A severe hyperosmolar state caused by extreme hyperglycemia (often $>600\,mg/dL$) and profound dehydration, primarily occurring in older adults with type 2 diabetes.

Inflammation

A protective, non-specific response to tissue injury, allergy, or pathogens involving redness, warmth, swelling, pain, and decreased function.

Osteoarthritis (OA)

A progressive degenerative disorder involving loss of articular cartilage, narrowing of joint space, and the formation of bony osteophytes.

Heberden nodes

Hard, bony enlargements located at the distal interphalangeal (DIP) joints in patients with osteoarthritis.

Bouchard nodes

Hard, bony enlargements located at the proximal interphalangeal (PIP) joints in patients with osteoarthritis.

Rheumatoid Arthritis (RA)

A systemic autoimmune inflammatory disease where the immune system attacks synovial tissue, leading to chronic synovitis and joint deformity.

Methotrexate

A common disease-modifying therapy (DMARD) for RA typically taken weekly; toxicity can cause bone marrow suppression and hepatotoxicity.

Gout

An inflammatory response to urate crystal deposition in joints and connective tissues caused by hyperuricemia.

Podagra

Acute gouty arthritis specifically affecting the first metatarsophalangeal joint (the great toe).

Colchicine

An anti-inflammatory medication used for acute gout attacks that decreases leukocyte migration; common toxicity begins with GI distress.

Allopurinol

A long-term prevention medication for gout that reduces uric acid production; requires reporting a rash immediately due to hypersensitivity risk.

HIV Viral Load

The best measure of ART response and disease activity; clinical goals are for this to be down and ideally undetectable.

CD4 Count

A measure of cell-mediated immunity; a count below $200\,cells/mm^3$ is diagnostic for AIDS.

ART (Antiretroviral Therapy)

Combination therapy that suppresses HIV replication; strict adherence is required to prevent drug resistance.

Hepatitis A

A fecal-oral viral hepatitis usually transmitted via contaminated food or water; typically acute and self-limiting.

Hepatitis B

A blood and body fluid-borne hepatitis that can become chronic and increases the risk for cirrhosis and liver cancer.

Hepatitis C

Hepatitis primarily transmitted blood-to-blood; often asymptomatic until chronic damage occurs but curable with direct-acting antivirals.

Hepatitis D

A hepatitis virus that cannot replicate without the presence of Hepatitis B; prevented by the HBV vaccine.

Asterixis

A hand-flapping tremor associated with elevated ammonia levels and hepatic encephalopathy in liver failure.

Influenza

A highly contagious viral respiratory infection with abrupt onset of fever, chills, severe headache, and myalgias.

COVID-19

A systemic viral illness caused by SARS-CoV-2 characterized by inflammation, endothelial dysfunction, and increased thrombotic risk.