90 - abnormal blood sugar, 91 - serum sodium / calcium Flashcards
Most common 2 triggers for DKA
lack of medication adherence
infection
What happens in DKA ?
Sx?
Shortage of insulin means that the cellular metabolism switches to fatty acids, producing ketone bodies. At the same time, the glucose remains in circulation.
abdo pain, vomiting, polyuria, altered consciousness, confusion, Kussmaul respirations, severe dehydration.
Seen on bloods of DKA
Raised glucose and ketones, metabolic acidosis, hypokalemia.
Mx of DKA
Aggressive fluid resus whilst monitoring for cerebral oedema (if this occurs then use mannitol and begin resus again)
Insulin 0.1 units/kg infusion
When blood glucose falls below 14, start 10% glucose solution until pt eating and drinking normally.
Monitor blood gases.
Replace potassium
Calcium gluconrate is cardioprotective
2 Functions of ADH / vasopressin
water retention and raises blood pressure via arteriole contraction.
What is conn’s? what happens?
Primary aldosteronism
Excessive production of aldosterone by adrenals leading to reduced renin.
Sx of conns
HTN, headaches
Usual cause of conns
adrenal adenoma -> excise
Drug Mx of conns caused by adrenal hyperplasia
dexamethasone
what is addison’s
Primary adrenal insufficiency; adrenal glands do not produce sufficient hormones.
Often autoimmune.
May be secondary (ACTH)
Sx addisons
Abdominal pain, weakness, increased skin pigmentation and weight loss.
Dx of addisons?
ACTH stimulation test.
Mx of addisons
Replace hormones with fludrocortisone and hydrocortisone
Sx , triggers, Mx of addisonian crisis?
hypotension, vomiting, lower back pain and LoC.
Triggered by infection, injury, surgery or stress.
Give hydrocortisone IM or IV with saline
sx of hypercalcaemia
Thrones: constipation and polyuria
Moans: bone pain
Stones: renal stone formation
Psychiatric overtones: confusion, lethargy and fatigue.
