Page 302 - 2021 IDMT Digital

DIABETES
Introduction:
• 7\SH ,, dLDEHWHV RFFXUV LQ DGXOWV RU FKLOGUHQ ZKHQ LQVXOLQ LV QR ORQJHU DEOH WR FDUU\
JOXFRVH LQWR FHOOV WR XVH IRU HQHUJ\
• 7KDW XQXVHG JOXFRVH WKHQ FLUFXODWHV LQ WKH EORRG GDPDJLQJ YHVVHOV DQG QHUYHV
• /RQJ WHUP XQFRQWUROOHG GLDEHWHV FDQ OHDG WR EOLQGQHVV KHDUW GLVHDVH DPSXWDWLRQ RI
OLPEV DQG GHDWK
• 7KLV GLVHDVH LV KLJKO\ DVVRFLDWHG ZLWK REHVLW\
Subjective:
• 6LJQV DQG 6\PSWRPV
o 7KH 3¶V
ƒ 3RO\GLSVLD IUHTXHQW WKLUVW
ƒ 3RO\SKDJLD IUHTXHQW KXQJHU
ƒ 3RO\XULD IUHTXHQW XULQDWLRQ
o :HLJKW ORVV
o 0DODLVH
• )RFXVHG +LVWRU\
o )UHTXHQF\ RI XULQDWLRQ
o )DPLO\ KLVWRU\
o (WKQLFLW\
Objective:
• 3K\VLFDO ([DP
o 9LWDO VLJQV OLNHO\ WR EH QRUPDO H[FHSW ZHLJKW REHVLW\
o 6NLQ FKDQJHV DFDQWKRVLV QLJULFDQV
o &DQGLGLDVLV RUDO RU IUHTXHQW YDJLQDO LQIHFWLRQV
• 7RROV
o /DE
ƒ 8$ SRVLWLYH NHWRQHV DQG JOXFRVH LQ XULQH
Assessment:
• 'LIIHUHQWLDO
o 7K\URLG GLVHDVH brady or tachycardia, goiter, eye findings
o 87, positive QLWULWHV OHXNRF\WH esterase RQ XULQH GLSVWLFN
o +,9 suspect LI RUDO FDQGLGLDVLV LV SUHVHQW
o 7\SH , dLDEHWHV YHU\ KLJK LQLWLDO EORRG VXJDUV less OLNHO\ WR KDYH IDPLO\ KLVWRU\
Plan:
• ,PPHGLDWHO\ (9$& RU WUDQVIHU
• ,I XQDEOH WR (9$& RU WUDQVIHU
o ,QVXOLQ LI DYDLODEOH DQG XQGHU SUHFHSWRU JXLGDQFH
o ,9 ZLWK IOXLG K\GUDWLRQ
o &KHFN %6 GDLO\ DQG ZDWFK IRU LQFUHDVLQJ V\PSWRPRORJ\
o /RZ FDUERK\GUDWH GLHW

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