Assessment prep Flashcards
Conditions that present with chest pain
-ACS, PE, MSK, rTAA, trauma
-costochondritis- inflammation where ribs join sternum, causing sharp pain when breathing or moving
-cocaine toxicity- occurs minutes to hours after excessive cocaine use
Conditions that present with abdo pain
-appendicitis- RLQ can worsen on palpation of LLQ
-acute cholecystitis- murphy’s sign, press hand below ribs and ask to breathe in
-bowel obstruction
-ovarian torsion
-ruptured ectopic pregnancy
-ACS
-rAAA
-renal colic
-blocked ureter
Conditions that present with altered LOC
-SAH
-stroke/ TIA
-syncope
-hypoglycaemia
-hyperglycaemia
-intoxication
-opiate OD
-addisons
-CO poisoning
-sepsis
-epileptic seizure
Conditions that present with limb pain
-ALI
-MSK
-cauda equina
-DVT
Conditions that present with SOB
-PE
-pneumonia
-COPD/ AECOPD
-asthma
-HF
-anaphylaxis
Pathophysiology hyperglycaemia
Hyperglycaemia happens when there’s too much glucose in the blood due to insufficient insulin action. In Type 2 diabetes, insulin resistance or deficiency means glucose can’t enter cells properly, so it builds up in the bloodstream.
Hyperosmolar Hyperglycaemic State (HHS)
HHS is a serious complication of severe hyperglycaemia, usually seen in elderly Type 2 diabetics. It develops over days to weeks and is triggered by infection, dehydration, or missed medications.
Glucose Builds Up in the Blood
Blood glucose rises above 30 mmol/L (your patient is at 18.2 mmol/L, so early signs could be developing).
Unlike diabetic ketoacidosis (DKA), there are no ketones because Type 2 diabetics still have some insulin, preventing fat breakdown.
Osmotic Diuresis & Severe Dehydration
The high glucose level draws water out of cells into the bloodstream.
The kidneys try to remove the excess glucose, causing excessive urination (polyuria).
This leads to severe dehydration and electrolyte imbalances, contributing to altered mental state.
Neurological Symptoms
Dehydration and electrolyte shifts can cause confusion, drowsiness, slurred speech, and eventually coma.
Hypercoagulability
HHS increases the risk of blood clots, which could explain the patient’s AF history—they are already at risk of strokes.
