Chapter 65 - Hyperglycemic Hyperosmolar Syndrome

Question 1

Three markers of HHS

Answer 1

severe hyperglycemia (>600 mg/dL)
minimal or absent urine ketones
serum osmolality more than 350 mOsm/kg

Question 2

Different parthenogenesis of HHS compared to DKA

Answer 2

Pathophy of HHS is similar to DKA but small amount of insulin and hepatic glucagon resistance inhibit lipolysis, thereby preventing ketosis and instead promoting HHS

Question 3

What’s the mechanism of neurologic signs secondary from HHS?

Answer 3

Develop secondary to cerebral dehydration induced by the severe hyperosmolality

Question 4

Concurrent disease associated with HHS

Answer 4

Renal failure, CHF, infection, neoplasia, other endocrinopathies (renal failure and CHF decrease GFR)

Question 5

T/F: pancreatitis: more common in dogs (1/3 of HHS) than cats (pancreatitis and hepatic disease appear to be uncommon concurrent disease in cats)

Answer 5

True

Question 6

Equstion of 1) osmolality, 2) effective osomlality, 3) corrected sodium

Answer 6

osmolality: 2(Na)+(BUN/2.8)+(Glu/18)
effective osmolality: 2(Na)+(Glu/18)
corrected sodium: Na + 1.6[(measured glucose-normal glucose)/100]

Question 7

hypernatremia: should be corrected slowly with a decrease of no more than what rate?

Answer 7

1 mEq/L/hr

Question 8

Insulin dosage to treat HHS compared to DKA?

Answer 8

50% of those used for DKA