Diabetes Cases Flashcards
What is compensation?
Compensation is a deliberate process that changes CO2 by breathing (Resp) or kidneys excretion/ retention of bicarb
If pH is low and pCO2 is low what is the issue?
Metabolic acidosis
If pH is low and pCO2 is high what is the issue?
Respiratory acidosis
If pH is high and pCO2 is low what is the issue?
Respiratory alkalosis
If pH is high and pCO2 is high what is the issue?
Metabolic alkalosis
How do you figure out osmolality?
NEED TO KNOW THIS FORMULA
Osmolality = 2(Na + K) + urea + glucose
Osmolality = charged molecules + uncharged molecules = cations (Na + K) + anions (Cl + HCO3) + urea + glucose
anions = cations to be neutral
What are the normal ranges for potassium, sodium, urea and glucose?
NEED TO KNOW
K: 3.5-5
Na: 135-145
Urea: 2.5-7.8
Glucose: No less than 3, no more than 11.8
What is the anion gap?
(Na + K) - (Cl+Bicarb)
if suspect DKA, extra anion is likely ketones (may also be lactate)
What is the normal anion gap?
16-20 mM
What is a cause of respiratory alkalosis?
Anxiety (hyperventilation)
What is normal osmolality?
295 mosm/ kg
What can stop brain from working (unconscious)?
Too acidic
Too dehydrated
What can cause a high anion gap?
Methanol
Ethanol
Lactate (e.g. in sepsis or metformin excess)
How can metformin causes lactate increase?
Metformin inhibits lactate conversion to glucose in the liver (in the Cori cycle)
What are the values you need to consider for Diabetes in Glucose Tolerance Test?
Fasting Glucose > 7 mM
Glucose Tolerance Test (75g at T=0), plasma glucose < 11.1 at 2 hrs
2h value = 7.8 - 111.1 = impaired tolerance (not diabetes)
