- 62-year-old female patient presented with complaints of increased urination, thirst, hunger, tiredness, and constipation.
- She has a history of hypertension for one year and was diagnosed with uncontrolled diabetes and peripheral neuropathy.
- Her blood sugar was 489 mg/dL, HbA1c was 14.0%, and blood pressure was 160/100 mm Hg.
- She was treated in the hospital with insulin, oral hypoglycemic drugs, and antihypertensives. Her blood pressure and symptoms improved over three days.
- She was discharged on medications including oral hypoglycemics and antihypertensives with counseling on lifestyle modifications like diet, exercise, and avoiding
This document discusses the different types of diabetes, their causes and symptoms. It covers Type 1 diabetes which occurs when the pancreas does not produce enough insulin, and Type 2 diabetes which happens when the pancreas does not make enough insulin or cells become insulin resistant. Symptoms of high and low blood sugar are explained. Treatment recommendations are provided for hypoglycemia and hyperglycemia. Normal blood sugar ranges are listed for different age groups. Lifestyle factors like diet, exercise and medication adherence are noted as important for diabetes management.
Based on the information provided:
- Betty should receive her usual Lantus dose as scheduled since it is a basal insulin that works continuously to control her blood sugar throughout the day and night. Missing the dose could lead to hyperglycemia.
- She should not receive any Humulin R (regular insulin) since she is NPO for surgery and regular insulin requires food to avoid hypoglycemia.
- She may receive her usual Humalog dose if her blood sugar is elevated, as Humalog is a rapid-acting insulin used to control post-meal blood sugars. However, since her current blood sugar of 130mg/dL is in a reasonable range, the Humalog dose can be held until after her surgery when she
Este documento describe la obstrucción intestinal y su manejo anestésico. Incluye las definiciones, etiología, fisiopatología, manifestaciones clínicas y de laboratorio, así como el manejo anestésico para la inducción, mantenimiento y extubación de pacientes con obstrucción intestinal. Se enfatiza la importancia de colocar vía central, sonda vesical y nasogástrica, y el uso de fluidoterapia para estos pacientes.
El documento presenta una introducción al manejo preoperatorio del paciente. Se define el manejo preoperatorio como la evaluación y preparación del paciente previo a un acto quirúrgico, el cual consta de una fase diagnóstica y una fase de preparación. En la fase diagnóstica se realiza una evaluación clínica del paciente, exámenes complementarios y clasificación del riesgo quirúrgico. En la fase de preparación se realizan medidas como control de comorbilidades, preparación psicológica y física del paciente.
El documento describe la importancia de la nutrición perioperatoria para reducir las complicaciones quirúrgicas. La malnutrición aumenta la morbilidad y mortalidad postoperatoria a través de una cicatrización deficiente, respuesta inmune alterada y mayor estancia hospitalaria. El soporte nutricional antes, durante y después de la cirugía puede prevenir estas complicaciones al mejorar el balance de nutrientes y restaurar la función tisular. La nutrición enteral temprana es preferible a la nutrición parenteral o al ayuno prolongado.
El documento describe el Síndrome de Mendelson, una complicación rara pero devastadora causada por la aspiración de contenido gástrico durante la anestesia. Explica los factores de riesgo, manifestaciones clínicas, clasificación y formas de prevención y tratamiento, incluyendo el ayuno adecuado, la maniobra de Sellick, la inducción rápida de secuencia y la intubación despierto para minimizar el riesgo de aspiración.
This patient is a 35-year-old woman with type 1 diabetes and poorly controlled hypertension. Her lab results show elevated fasting blood glucose, HbA1c, BUN, and urine albumin levels. A 24-hour dietary recall revealed she consumes foods high in sugar and fat like juice, cake, ice cream, and fast food. Her diet lacks nutrients like iron which has caused low Hct levels. The nutrition assessment identified behavioral, clinical, and intake issues including a preference for unhealthy foods due to lack of knowledge about diabetes management. Goals were set to increase fruit intake to control blood pressure, educate on carbohydrate counting and blood sugar control, and recommend a healthier diet and self-care activities.
- 62-year-old female patient presented with complaints of increased urination, thirst, hunger, tiredness, and constipation.
- She has a history of hypertension for one year and was diagnosed with uncontrolled diabetes and peripheral neuropathy.
- Her blood sugar was 489 mg/dL, HbA1c was 14.0%, and blood pressure was 160/100 mm Hg.
- She was treated in the hospital with insulin, oral hypoglycemic drugs, and antihypertensives. Her blood pressure and symptoms improved over three days.
- She was discharged on medications including oral hypoglycemics and antihypertensives with counseling on lifestyle modifications like diet, exercise, and avoiding
This document discusses the different types of diabetes, their causes and symptoms. It covers Type 1 diabetes which occurs when the pancreas does not produce enough insulin, and Type 2 diabetes which happens when the pancreas does not make enough insulin or cells become insulin resistant. Symptoms of high and low blood sugar are explained. Treatment recommendations are provided for hypoglycemia and hyperglycemia. Normal blood sugar ranges are listed for different age groups. Lifestyle factors like diet, exercise and medication adherence are noted as important for diabetes management.
Based on the information provided:
- Betty should receive her usual Lantus dose as scheduled since it is a basal insulin that works continuously to control her blood sugar throughout the day and night. Missing the dose could lead to hyperglycemia.
- She should not receive any Humulin R (regular insulin) since she is NPO for surgery and regular insulin requires food to avoid hypoglycemia.
- She may receive her usual Humalog dose if her blood sugar is elevated, as Humalog is a rapid-acting insulin used to control post-meal blood sugars. However, since her current blood sugar of 130mg/dL is in a reasonable range, the Humalog dose can be held until after her surgery when she
Este documento describe la obstrucción intestinal y su manejo anestésico. Incluye las definiciones, etiología, fisiopatología, manifestaciones clínicas y de laboratorio, así como el manejo anestésico para la inducción, mantenimiento y extubación de pacientes con obstrucción intestinal. Se enfatiza la importancia de colocar vía central, sonda vesical y nasogástrica, y el uso de fluidoterapia para estos pacientes.
El documento presenta una introducción al manejo preoperatorio del paciente. Se define el manejo preoperatorio como la evaluación y preparación del paciente previo a un acto quirúrgico, el cual consta de una fase diagnóstica y una fase de preparación. En la fase diagnóstica se realiza una evaluación clínica del paciente, exámenes complementarios y clasificación del riesgo quirúrgico. En la fase de preparación se realizan medidas como control de comorbilidades, preparación psicológica y física del paciente.
El documento describe la importancia de la nutrición perioperatoria para reducir las complicaciones quirúrgicas. La malnutrición aumenta la morbilidad y mortalidad postoperatoria a través de una cicatrización deficiente, respuesta inmune alterada y mayor estancia hospitalaria. El soporte nutricional antes, durante y después de la cirugía puede prevenir estas complicaciones al mejorar el balance de nutrientes y restaurar la función tisular. La nutrición enteral temprana es preferible a la nutrición parenteral o al ayuno prolongado.
El documento describe el Síndrome de Mendelson, una complicación rara pero devastadora causada por la aspiración de contenido gástrico durante la anestesia. Explica los factores de riesgo, manifestaciones clínicas, clasificación y formas de prevención y tratamiento, incluyendo el ayuno adecuado, la maniobra de Sellick, la inducción rápida de secuencia y la intubación despierto para minimizar el riesgo de aspiración.
This patient is a 35-year-old woman with type 1 diabetes and poorly controlled hypertension. Her lab results show elevated fasting blood glucose, HbA1c, BUN, and urine albumin levels. A 24-hour dietary recall revealed she consumes foods high in sugar and fat like juice, cake, ice cream, and fast food. Her diet lacks nutrients like iron which has caused low Hct levels. The nutrition assessment identified behavioral, clinical, and intake issues including a preference for unhealthy foods due to lack of knowledge about diabetes management. Goals were set to increase fruit intake to control blood pressure, educate on carbohydrate counting and blood sugar control, and recommend a healthier diet and self-care activities.
This presentation gives an insight to management of diabetic patient with regard to dental treatments or procedures.
It also highlight the major emergencies that arises in treatment of diabetic patient and how to manage such incidences.
Manejo perioperatorio de las arritmias en cirugía no cardiacalemaotoya
1. Las arritmias cardíacas son las anomalías cardiovasculares perioperatorias más frecuentes y se producen principalmente por alteraciones en la automaticidad y conducción del corazón. 2. Los factores más comunes asociados con arritmias incluyen hipoxemia, hipercapnia, acidosis e hipotensión, así como el uso de ciertos medicamentos anestésicos. 3. El documento proporciona recomendaciones para el manejo de diferentes tipos de arritmias como bradicardia, taquicardia y fibrilación ventricular.
Diabetes mellitus is a clinical syndrome characterized by hyperglycemia. There are two main types: type 1 caused by autoimmune destruction of pancreatic beta cells leading to insulin deficiency; and type 2 caused by insulin resistance and defective insulin secretion. Diabetes is diagnosed based on fasting blood glucose, oral glucose tolerance test, or HbA1c levels. Complications include hypoglycemia, ketoacidosis, hyperglycemic hyperosmolar syndrome, and various oral manifestations. Management involves lifestyle changes, medications to control blood sugar like insulin, and treating complications. Dentists must carefully manage diabetes patients to prevent emergencies during dental procedures.
This case study describes a 30-year-old male with type 1 diabetes who experiences frequent hypoglycemia due to inconsistent carbohydrate intake from irregular meal timing and snacks high in simple carbohydrates. His current HbA1c is 8.1% and casual blood glucose is 195 mg/dL. The registered dietitian will provide nutrition education and counseling to establish consistent carbohydrate intake at meals and snacks, teach carbohydrate counting, and encourage healthier food choices to improve blood glucose control and reduce hypoglycemic episodes. Treatment goals include decreasing HbA1c to under 7% and casual blood glucose to under 135 mg/dL.
This is a brief discussion on diabetes mellitus as medical emergency that can be encountered in any dental office.
What to do in such conditions is what I've briefly tried to explain over here.
Regards,
Dr. Abhishek Sharma
(M.D.S - 2016 Batch ; Oral & Maxillofacial Surgery)
The document discusses various laboratory tests used to evaluate liver function and disease. It describes tests for hepatocellular damage like ALT and AST, tests for cholestasis like alkaline phosphatase, and tests for liver synthetic function like albumin. Common causes of abnormal liver enzymes are also summarized, along with risk factors for liver disease.
Odontologia UNIEURO - Disciplina de cirurgia Prof. Marcelo GomesMarcelo Gomes
[1] Os cuidados pré-operatórios em cirurgia bucal incluem a avaliação das condições clínicas do paciente através de anamnese, exame clínico e exames complementares para verificar se o paciente está apto para o procedimento cirúrgico. [2] É importante fornecer informações e orientações claras ao paciente sobre o procedimento, cuidados pré e pós-operatório para controlar a ansiedade e aumentar a confiança. [3] A assepsia bucal, suspensão de fumo, á
The document provides 5 tips for taking control of diabetes prevention through lifestyle changes: 1) Get more physical activity to lose weight, lower blood sugar, and reduce heart disease risk. 2) Get plenty of fiber to improve blood sugar control and promote weight loss. 3) Choose whole grains for steady blood sugar. 4) Lose extra weight through diet and exercise as overweight increases diabetes risk. 5) Skip fad diets and make consistent healthier food and lifestyle choices for long-term diabetes prevention.
O documento discute a importância da avaliação pré-operatória para reduzir riscos, com foco na anamnese e exame físico detalhados para identificar comorbidades. Realizar exames complementares de forma individualizada de acordo com a idade, comorbidades e tipo de cirurgia planejada. A avaliação pré-operatória é fundamental para o sucesso da cirurgia e de responsabilidade do cirurgião.
Perform the A1C test at least two times a year in patients who are meeting treatment goals (and who have stable glycemic control). Perform the A1C test quarterly in patients whose therapy has changed or who are not meeting glycemic goals. A1C testing should be performed routinely in all patients with diabetes. The frequency of A1C testing should be dependent on the clinical situation, the treatment regimen used, and the clinician’s judgment. Some patients with stable glycemia well within target may do well with testing only twice per year. Unstable or highly intensively managed patients (e.g., pregnant type 1 diabetic women) may require testing more frequently than every 3 months.
This document discusses diabetes mellitus, including its classification, clinical features, complications, diagnosis, and management. It covers the two primary types of diabetes - type 1 characterized by lack of insulin production and type 2 related to insulin resistance. The acute complications include ketoacidosis, hypoglycemia, and hyperosmolar coma. Chronic complications affect the microvasculature like retinopathy, neuropathy, and nephropathy as well as the macrovasculature with atherosclerosis and hypertension. Good management can help prevent or delay the serious complications of diabetes.
Este documento proporciona información sobre la hemoglobina glicosilada (HbA1c) y su importancia para monitorear el control glucémico en pacientes con diabetes. Explica que la HbA1c mide el promedio de los niveles de glucosa en los últimos 3 meses y que valores menores al 7% son deseables para prevenir complicaciones. También brinda recomendaciones sobre la frecuencia de medición de HbA1c y los rangos glucémicos objetivo según la edad para un buen control de la diabetes.
Laboratory diagnosis of Diabetes mellitus Monika Nema
This document summarizes Dr. Monika Nema's presentation on laboratory diagnosis and monitoring of diabetes mellitus. It discusses various laboratory tests used for diagnosis of diabetes including estimation of blood glucose, oral glucose tolerance test, and glycated hemoglobin (HbA1c). It also describes tests used to assess glycemic control such as periodic HbA1c measurement and self-monitoring of blood glucose. Laboratory tests for screening and diagnosis of gestational diabetes are also summarized.
Glycosylated hemoglobin (HbA1c) represents the average plasma glucose over the previous 2-3 months and is measured to monitor long-term glycemic control in patients with diabetes. The document discusses the relationship between HbA1c levels and diabetes complications, factors that affect HbA1c, and recommendations for using HbA1c to diagnose diabetes. International expert committees now recommend using HbA1c ≥6.5% to diagnose diabetes due to standardization of assays and its correlation with complications.
This document discusses the management of medically compromised patients for dental treatment. It covers several topics:
1. The importance of recognizing a patient's existing medical conditions and adequately preparing for treatment, including premedication, prophylaxis, and adjustments.
2. Classifying patients based on their physical condition according to the ASA, and determining appropriate treatment settings based on a patient's classification.
3. Stress reduction protocols to minimize stress during dental appointments.
4. Guidelines for treating patients with specific cardiovascular and hematologic conditions, including angina, hypertension, arrhythmias, myocardial infarction, leukemia, and hemophilia. Considerations include consultation, medication adjustments, stress reduction, local anesthesia modifications,
Management of a diabetic patient in dental officelalola
This document discusses the management of diabetic patients in a dental office. It notes that diabetes is a chronic metabolic disorder caused by insulin deficiency that results in high blood glucose levels. It provides information on assessing a patient's diabetes status and control, such as by inquiring about medications and recent HbA1c levels. For patients with good control, most dental treatments can be provided, while those with complications may require hospital care. It also describes how to treat hypoglycemic episodes and provide post-operative diet instructions and oral hygiene recommendations to diabetic patients.
The document discusses the importance of preoperative assessment and preparation of patients prior to surgery. Key aspects of assessment include taking a thorough medical history, conducting a physical examination, evaluating nutritional status, ordering relevant investigations, and determining surgical risk. Important elements of preparation are obtaining informed consent, preventing cardiovascular and respiratory complications, reducing risk of aspiration, preparing the bowels if needed, and ensuring adequate sleep, skin preparation, catheterization and pre-medication when applicable. The goals are to identify risk factors, optimize the patient's health status, and reduce postoperative complications.
This presentation gives an insight to management of diabetic patient with regard to dental treatments or procedures.
It also highlight the major emergencies that arises in treatment of diabetic patient and how to manage such incidences.
Manejo perioperatorio de las arritmias en cirugía no cardiacalemaotoya
1. Las arritmias cardíacas son las anomalías cardiovasculares perioperatorias más frecuentes y se producen principalmente por alteraciones en la automaticidad y conducción del corazón. 2. Los factores más comunes asociados con arritmias incluyen hipoxemia, hipercapnia, acidosis e hipotensión, así como el uso de ciertos medicamentos anestésicos. 3. El documento proporciona recomendaciones para el manejo de diferentes tipos de arritmias como bradicardia, taquicardia y fibrilación ventricular.
Diabetes mellitus is a clinical syndrome characterized by hyperglycemia. There are two main types: type 1 caused by autoimmune destruction of pancreatic beta cells leading to insulin deficiency; and type 2 caused by insulin resistance and defective insulin secretion. Diabetes is diagnosed based on fasting blood glucose, oral glucose tolerance test, or HbA1c levels. Complications include hypoglycemia, ketoacidosis, hyperglycemic hyperosmolar syndrome, and various oral manifestations. Management involves lifestyle changes, medications to control blood sugar like insulin, and treating complications. Dentists must carefully manage diabetes patients to prevent emergencies during dental procedures.
This case study describes a 30-year-old male with type 1 diabetes who experiences frequent hypoglycemia due to inconsistent carbohydrate intake from irregular meal timing and snacks high in simple carbohydrates. His current HbA1c is 8.1% and casual blood glucose is 195 mg/dL. The registered dietitian will provide nutrition education and counseling to establish consistent carbohydrate intake at meals and snacks, teach carbohydrate counting, and encourage healthier food choices to improve blood glucose control and reduce hypoglycemic episodes. Treatment goals include decreasing HbA1c to under 7% and casual blood glucose to under 135 mg/dL.
This is a brief discussion on diabetes mellitus as medical emergency that can be encountered in any dental office.
What to do in such conditions is what I've briefly tried to explain over here.
Regards,
Dr. Abhishek Sharma
(M.D.S - 2016 Batch ; Oral & Maxillofacial Surgery)
The document discusses various laboratory tests used to evaluate liver function and disease. It describes tests for hepatocellular damage like ALT and AST, tests for cholestasis like alkaline phosphatase, and tests for liver synthetic function like albumin. Common causes of abnormal liver enzymes are also summarized, along with risk factors for liver disease.
Odontologia UNIEURO - Disciplina de cirurgia Prof. Marcelo GomesMarcelo Gomes
[1] Os cuidados pré-operatórios em cirurgia bucal incluem a avaliação das condições clínicas do paciente através de anamnese, exame clínico e exames complementares para verificar se o paciente está apto para o procedimento cirúrgico. [2] É importante fornecer informações e orientações claras ao paciente sobre o procedimento, cuidados pré e pós-operatório para controlar a ansiedade e aumentar a confiança. [3] A assepsia bucal, suspensão de fumo, á
The document provides 5 tips for taking control of diabetes prevention through lifestyle changes: 1) Get more physical activity to lose weight, lower blood sugar, and reduce heart disease risk. 2) Get plenty of fiber to improve blood sugar control and promote weight loss. 3) Choose whole grains for steady blood sugar. 4) Lose extra weight through diet and exercise as overweight increases diabetes risk. 5) Skip fad diets and make consistent healthier food and lifestyle choices for long-term diabetes prevention.
O documento discute a importância da avaliação pré-operatória para reduzir riscos, com foco na anamnese e exame físico detalhados para identificar comorbidades. Realizar exames complementares de forma individualizada de acordo com a idade, comorbidades e tipo de cirurgia planejada. A avaliação pré-operatória é fundamental para o sucesso da cirurgia e de responsabilidade do cirurgião.
Perform the A1C test at least two times a year in patients who are meeting treatment goals (and who have stable glycemic control). Perform the A1C test quarterly in patients whose therapy has changed or who are not meeting glycemic goals. A1C testing should be performed routinely in all patients with diabetes. The frequency of A1C testing should be dependent on the clinical situation, the treatment regimen used, and the clinician’s judgment. Some patients with stable glycemia well within target may do well with testing only twice per year. Unstable or highly intensively managed patients (e.g., pregnant type 1 diabetic women) may require testing more frequently than every 3 months.
This document discusses diabetes mellitus, including its classification, clinical features, complications, diagnosis, and management. It covers the two primary types of diabetes - type 1 characterized by lack of insulin production and type 2 related to insulin resistance. The acute complications include ketoacidosis, hypoglycemia, and hyperosmolar coma. Chronic complications affect the microvasculature like retinopathy, neuropathy, and nephropathy as well as the macrovasculature with atherosclerosis and hypertension. Good management can help prevent or delay the serious complications of diabetes.
Este documento proporciona información sobre la hemoglobina glicosilada (HbA1c) y su importancia para monitorear el control glucémico en pacientes con diabetes. Explica que la HbA1c mide el promedio de los niveles de glucosa en los últimos 3 meses y que valores menores al 7% son deseables para prevenir complicaciones. También brinda recomendaciones sobre la frecuencia de medición de HbA1c y los rangos glucémicos objetivo según la edad para un buen control de la diabetes.
Laboratory diagnosis of Diabetes mellitus Monika Nema
This document summarizes Dr. Monika Nema's presentation on laboratory diagnosis and monitoring of diabetes mellitus. It discusses various laboratory tests used for diagnosis of diabetes including estimation of blood glucose, oral glucose tolerance test, and glycated hemoglobin (HbA1c). It also describes tests used to assess glycemic control such as periodic HbA1c measurement and self-monitoring of blood glucose. Laboratory tests for screening and diagnosis of gestational diabetes are also summarized.
Glycosylated hemoglobin (HbA1c) represents the average plasma glucose over the previous 2-3 months and is measured to monitor long-term glycemic control in patients with diabetes. The document discusses the relationship between HbA1c levels and diabetes complications, factors that affect HbA1c, and recommendations for using HbA1c to diagnose diabetes. International expert committees now recommend using HbA1c ≥6.5% to diagnose diabetes due to standardization of assays and its correlation with complications.
This document discusses the management of medically compromised patients for dental treatment. It covers several topics:
1. The importance of recognizing a patient's existing medical conditions and adequately preparing for treatment, including premedication, prophylaxis, and adjustments.
2. Classifying patients based on their physical condition according to the ASA, and determining appropriate treatment settings based on a patient's classification.
3. Stress reduction protocols to minimize stress during dental appointments.
4. Guidelines for treating patients with specific cardiovascular and hematologic conditions, including angina, hypertension, arrhythmias, myocardial infarction, leukemia, and hemophilia. Considerations include consultation, medication adjustments, stress reduction, local anesthesia modifications,
Management of a diabetic patient in dental officelalola
This document discusses the management of diabetic patients in a dental office. It notes that diabetes is a chronic metabolic disorder caused by insulin deficiency that results in high blood glucose levels. It provides information on assessing a patient's diabetes status and control, such as by inquiring about medications and recent HbA1c levels. For patients with good control, most dental treatments can be provided, while those with complications may require hospital care. It also describes how to treat hypoglycemic episodes and provide post-operative diet instructions and oral hygiene recommendations to diabetic patients.
The document discusses the importance of preoperative assessment and preparation of patients prior to surgery. Key aspects of assessment include taking a thorough medical history, conducting a physical examination, evaluating nutritional status, ordering relevant investigations, and determining surgical risk. Important elements of preparation are obtaining informed consent, preventing cardiovascular and respiratory complications, reducing risk of aspiration, preparing the bowels if needed, and ensuring adequate sleep, skin preparation, catheterization and pre-medication when applicable. The goals are to identify risk factors, optimize the patient's health status, and reduce postoperative complications.