Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

2 Endocrine > Diabetic Emergencies > Flashcards

Diabetic Emergencies Flashcards

1
Q

when does DKA occur?

A

in a state of absolute or relative insulin deficiency PLUS an increase in glucose-increasing hormones eg glucagon etc

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

can DKA occur in both diabetic types?

A

yes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what happens in response to absolute or relative deficiency?

A

stress hormones activated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what 4 processes occur as a response to stress hormone activation?

A

inc lipolysis
dec glucose uilisation
inc proteolysis
inc glycogenolysis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what happens when lipolysis is increased?

A

more free fatty acids go to liver
ketones are made
get an acidosis
lactate is produced

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

do you get an acidosis or alkalosis from ketones?

A

acidosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what 3 process contribute to hyperglycaemia in DKA?

A

decreased glucose utilisation
proteolysis
glycogenolysis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what are the negative effects glycosuria has on the body?

A

electrolyte loss
dehydration
decreased renal function

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what factor other than acidosis produces lactate?

A

dehydration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

main cause of hyperosmolar hyperglycaemic state?

A

hyperglycaemia causing dehydration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what level on urinalysis would indicate the ketonuria needed for diagnosis of DKA?

A

> 2+

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what level of ketone in the blood is needed to diagnose DKA?

A

> 3mmol/l

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what level is blood glucose usually at it in DKA?

A

> 11mmol/l

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what should bicarb levels be at in DKA?

A

<15mmol/l

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

causes of DKA?

A

infection
drugs/alcohol
non adherence to treatment
newly diagnosed diabetes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what symptoms would make you think the DKA is osmotic related?

A

thirst
polyuria
dehydration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what symptoms would make you think the DKA is ketone body related?

A 
flushed
vomiting
abdo pain
tender
kussmaul breathing
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what glucose level is suggestive of DKA?

A

around 40mmol/l

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what potassium level is suggestive of DKA?

A

> 5.5

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q 
which of these should be raised/low in DKA? :
creatinine
sodium
lactate
amylase
A

raised
reduced
raised
raised

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what blood ketone level is found in DKA?

A

> 5

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

nromal range for amylase?

A

0-100

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

risks of DKA?

A

ARDS
hypokalaemia
sepsis
thromboembolism

24
Q

most common cause of death in kids with DKA?

A

cerebral oedema

25
Q

how should you treat DKA?

A 
manage in HDU
replace fluids, insulin, potassium
monitor K+
prescribe LMWH prophylaxis
check for sepsis
26
Q

how could you check for sepsis?

A

CXR

blood culture

27
Q

what does a urine ketone monitor test?

A

acetoacetate

28
Q

urine ketone monitors monitor ketone levels at what time?

A

2-4hrs previously

29
Q

what chemical does blood ketone monitoring measure?

A

betahydroxybutyrate

30
Q

should the patient be given a ketone meter?

A

yes

31
Q

what instances other than DKA would you admit someone with T1DM?

A 
unable to tolerate oral fluids
persistent vomiting
hypo alot
persistent positive ketones
abdo pain
breathlessness
32
Q

HHS affects what age group?

A

elderly

33
Q

what do HHS patients tend to have consumed before they present?

A

high intake of refined carbs

34
Q

risks of HHS?

A 
stroke
MI
sepsis
steroids
thiazides
35
Q

clinical presentation of HHS?

A

hypovolaemia
hyperglycaemia
hyperosmolar state

36
Q

how is the hyperglycaemia different in HHS compared to DKA?

A

no ketonaemia or acidosis

37
Q

do glucose levels tend to be higher in DKA or HHS?

A

HHS

38
Q

what ion may be raised on biochem in HHS?

A

sodium

39
Q

is HHS more common in type 1 or 2?

A

type 2

40
Q

treatment for HHS?

A

diet

OHA

41
Q

what causes HHS?

A

new diagnosis of type 2

infection

42
Q

should you give fluids for HHS?

A

yes but be careful incase of overload

43
Q

what should you give for HHS to be carful of co-morbidities?

A

screen for vascular event
sepsis
give LMWH

44
Q

should you give insulin for HHS?

A

only if ketonaemia or ketonuria

45
Q

what is lactate’s role in the glucose pathway?

A

end product of anaerobic glycolysis

46
Q

normal range for lactate?

A

0.6-1.2

47
Q

when is lactate at its lowest?

A

fasted state

48
Q

main pathology involved in lactic acidosis?

A

tissue hypoxaemia

49
Q

consequences of type a lactic acidosis?

A

cardiogenic shock
hypovolaemic shock
sepsis
infarction

50
Q

what diseases can type b lactic acidosis occur in?

A

leukaemia
liver disease
diabetes

51
Q

at what level is lactic acidosis a risk?

A

> 5mmol

52
Q

clinical features of lactic acidosis?

A

hyperventilation
mental confusion
coma

53
Q

what medication can cause lactic acidosis?

A

metformin

54
Q

is bicarbonate raised or decreased in lactic acidosis?

A

decreased

55
Q

normal range of ion gap?

A

10 to 18mmol

56
Q

what is the ion gap?

A

[Na + K] - [HCO3+Cl]

57
Q

what is euglycaemic DKA?

A

DKA in absence of hyperglycaemia

2 Endocrine (35 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions