Diabetes CPC

Question 1

How is the diagnosis of diabetes confirmed

Answer 1

HbA1c >6.5%

Question 2

What are the causes of metabolic alkalosis (3)

Answer 2

H+ loss (e.g. vomiting).
Hypokalaemia
Ingestion of bicarbonate.

Question 3

How does metabolic alkalosis affect ventilation and CO2

Answer 3

Inhibits ventilation and CO2 increases.

Question 4

What are the causes of hypokalaemia (3)

Answer 4

Intestinal loss (diarrhoea, vomiting, fistula) 
Renal loss (mineralocorticoid excess, diuretics, renal tubular disease) 
Redistribution (insulin, alkalosis)

Question 5

How does hypokalaemia cause alkalosis (cellular) (3)

Answer 5

Low serum potassium leads to a shift of hydrogen ions into cells, leaving an extracellular alkalosis.

Question 6

How does alkalosis cause a hypokalaemic alkalosis

Answer 6

Potassium moves into cells (instead of hydrogen)

Question 7

How does hypokalaemia cause alkalosis (kidneys)

Answer 7

Lack of intracellular potassium leads to increased excretion of hydrogen in exchange for sodium.
This produces an acidic urine and increased generation of bicarbonate.

Question 8

What is a prime cause of ectopic ACTH secretion

Answer 8

Lung cancer.

Question 9

How is diabetic glomerular kidney disease managed

Answer 9

It is end stage renal failure and will need lifelong dialysis