Diabetic Emergencies Flashcards
DKA is more common in T_DM
DKA is more common in T1DM
absolute or relative insulin deficiency results in following:
_____glycaemia
_______molar
_____sis
HYPERglycaemia
HYPERSOmolar
ACIDOsis
biochemical diagnosis of DKA:
ketonaemia > _mmol/L or significant ketonuria
blood glucose > __ mmol/L or known DM
bicarbonate < __ mmol/L or venous pH < ___
biochemical diagnosis of DKA:
ketonaemia > 3mmol/L or significant ketonuria
blood glucose > 11 mmol/L or known DM
bicarbonate < 15 mmol/L or venous pH < 7.3
name the precipitants of DKA
newly diagnosed
infection
illicit drug and alcohol use
poor self management
name the 2 osmotic related typical symptoms and signs of DKA
thirst and polyuria
dehydration
name the 4 ketone body related typical symptoms and signs of DKA
flushed
vomiting
abdominal pain
breathless - kussmaul’s respiration
classical biochemistry of DKA at diagnosis:
glucose - potassium - creatinine - sodium - lactate - blood ketones - bicarbonate - amylase - WBC -
glucose - median of 40mmol/L potassium - raised creatinine - raised sodium - low lactate - raised blood ketones - above 5 bicarbonate - <10 amylase - raised WBC - median 25
name the common complication of the brain in DKA
cerebral oedema
name the 2 common complications of the respiratory and GI system in DKA
adult respiratory distress. syndrome
enlarged stomach at risk of aspiration pneumonia
name the common complication of the heart in DKA
cardiac arrest
management of DKA?
replace losses:
fluid
insulin
potassium
phosphate and bicarbonate rarely replaced
prescribe prophylactic LMWH
in the event of DKA, what should the patient be given?
a ketone meter
HHS biochemical diagnosis:
hypo/hypervolaemia
hypo/hyperglycaemia
no _____aemia
bicarbonate > 15 mmol/L
osmolarity >___ mosmol/kg
HHS biochemical diagnosis:
HYPOvolaemia
hyperglycaemia
no KETONaemia
bicarbonate > 15 mmol/L
osmolarity >320 mosmol/kg
HHS often presents in what 2 types of people?
older patients
young afro-carribeans
what is normally consumed before HHS attack?
high refined carbohydrate meal
there is a higher glucose in DKA/HHS in comparison to DKA/HHS
there is a higher glucose in HHS in comparison to DKA
there is significant ______ impairment in HHS
there is significant RENAL impairment in HHS
sodium is often _____ in HHS
sodium is often HIGH in HHS
patients with HHS/DKA is less ketogenic/acidotic than those with HHS/DKA
patients with HHS is less ketogenic/acidotic than those with DKA
raised osmolarity in those with ___
raised osmolarity in those with HHS
osmolarity calculation?
2x[Na] + urea + glucose
DKA or HSS:
younger
DKA
DKA or HSS:
older
HHS
DKA or HSS:
T2DM
HHS
DKA or HSS:
T1DM
DKA
DKA or HSS:
new diagnosis or infection
HHS
DKA or HSS:
diuretics and/or steroid and fizzy drinks can cause
HHS
DKA or HSS:
10-50% mortality
HHS
DKA or HSS:
treatment is diet/OHA/(insulin
HHS
DKA or HSS:
treatment is insulin
DKA
DKA or HSS:
<2% mortality
DKA
DKA or HSS:
insulin omission
DKA
DKA or HSS:
insulin deficiency
DKA
treatment for alcohol-induced ketones-acidosis
IV Pabrinex
IV fluids
IV anti-emetics
insulin may be required
what is very high in both DKA and HHS?
glucose
