Diabetes CPC

Question 1

Definitions of diabetes

Answer 1

Fasting plasma glucose > 7 mmol/L
OGTT 2 hour plasma glucose > 11.1 mmol/L
HbA1c > 48 mmol/L

Question 2

What is the link between hypokalaemia and alkalosis?

Answer 2

Low potassium causes shift of hydrogen ions into cells, thus extraceullar acidosis

Question 3

Causes of hypokalaemic acidosis

Answer 3

Intestinal loss - D&V, fistula
Renal loss - mineralocorticoid excess, renal tubular disease
Redistribution - insulin, alkalosis

Question 4

What can cause renal loss of K+?

Answer 4

Conn’s syndrome - high sodium, low potassium
Excess cortisol
Increased sodium delivery to distal nephron
Osmotic diuresis

Question 5

What are rare causes of hypokalaemia?

Answer 5

Renal tubular acidosis 1 and 2

Hypomagnesaemia

Question 6

Which cause of Cushing’s syndrome is most commonly associated with hypokalaemia?

Answer 6

Ectopic ACTH - causes such high levels of cortisol that they start binding to aldosterone

Question 7

What can dehydration do to the kidneys?

Answer 7

Acute tubular necrosis