21 - diabetic emergencies Flashcards
1
Q
what is triad of DKA
A
- hyperglycemia
- ketosis
- acidosis
2
Q
what type of DM is DKA primarily in
A
1
3
Q
2 main patho concepts in DKA
A
- relative insulin def.
- counter regulatory hormone excess due to failure of normal mechanisms
- glucagon, catecholamine, cortisol, GH
4
Q
10 causes of DKA
A
- lack of insulin
- infection
- MI
- PE
- stroke
- pnacreatitis
- substance abuse
- meds
- trauma
- surg.
5
Q
DKA signs and Sx
A
DKA
Diuresis, delirium/dizzy, dehydration
Kussmaul breathing, keto breath
Abdo pain
6
Q
3 main goals of DKA Tx
A
- restore volume
- correct lyte imbalance
- replensh insulin
7
Q
what is fluid replacement
A
give half amount lost in first 8 hours
- 1-2L NS in first hour
- once glucose falls below 16, change to D5W
8
Q
when to start giving insulin
A
once K levels reach >3.3 and BP restored
9
Q
how to dose Kcl
A
based on the levels of K found in the serum
10
Q
role for bicarb in therapy
A
not one unless pH is
11
Q
big 3 of DKA Tx
A
- fluid resus
- glucose control with insulin
- correct K
12
Q
what is dreaded outcome in DKA
A
cerebral edema
13
Q
what defines hyperosmolar hyperglycemic state (HHS)
A
glucose >33
ph>7.3
bicarb>15
AG320
14
Q
what is key feature to diff DKA and HHS
A
ketones
15
Q
how are DKA and HHS diff. in presentation
A
HHS over days to weeks
