Complications of glucose disorders Flashcards
1
Q
Lactic acidosis- Eti
A
- Accumulation of excess lactic acid in blood
- Uncommon in DM
- Metformin tx patients
- Kidney failure
2
Q
Lactic acidosis- Sx
A
- Hyperventilation
- Rapid onest
- Sx of tissue hypoxia or vascular collapse
3
Q
Lactic acidosis- Dx
A
- Low pH & Bicarb
- High anion gap
- Absent ketones
- High lactic acid concentration
4
Q
Lactic acidosis- Tx
A
- Oxygenation & pefursion
- Tx underlying cause
- Cover for sepsis
5
Q
Hyperglycemic Hyperosmolar- Eti
A
- Rarer than DKA, middle aged to elderly
- Infection, MI, stroke precipitates
- Drugs & glucose loading
- Underlying CKD or HF
6
Q
Hyperglycemic Hyperosmolar- Sx
A
- Insidious onset- weak, poly uria & dipsia
- Reduced fluid intake, lack of thirst, nausea, no access
- lethargy & confusion
- Profound dehydration, lethargy, coma
7
Q
Hyperglycemic Hyperosmolar- Dx
A
- Glucose >600
- High serum osmol
- No acidosis, normal anion gap
- Pre-renal azotemia
8
Q
Hyperglycemic Hyperosmolar- Tx
A
- Fluid replacement to restore urinary output
- Insulin
- Replete electrolytes if needed
9
Q
Diabetic ketoacidosis- Eti
A
- Initial manifestation of DM 1
- Complication of insulin pump
- Sepsis, stress or trauma in DM 2
- Poor compliance
- 5-8 per 1000 persons
10
Q
Diabetic ketoacidosis- Sx
A
- Polyuria, dipsia, fatigue, N/V & mental stupor
- Drowsiness
- Fruity, rapid breathing
- Hypotension & tachy
- Hypothermia
- Abd pain
11
Q
Diabetic ketoacidosis- Dx
A
- Hyperglycemia
- Acidosis <7.3
- Serum ketones
- Elevated BUN & creatinine
12
Q
Diabetic ketoacidosis- Tx
A
- Regular insulin- loading dose
- Fluids
- Bicarb
- Potassium
13
Q
Dawn phenomenon- Eti
A
- Waning of circulating insulin by morning
- Blood sugar is high at 3 am
- Low am blood glucose
14
Q
Somogyi Effect- Eti
A
- Nocturnal hypoglycemia leading to counter regulatory
- Blood sugar is low at 3 am
- high blood glucose in am
15
Q
Dawn effect- Tx
A
Increase evening dose of insulin or give prior to bed
