Diabetic Ketoacidosis Flashcards

1
Q

What precipitates diabetic ketoacidosis

A

A new T1DM diagnosis
Not taking insulin
Fasting
Stress

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2
Q

Effects of elevated insulin

A

High HGO and deficient muscle glucose uptake

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3
Q

How does insulin deficiency result in an increased HGO

A

Insulin should inhibit proteolysis and lipolysis but if is deficient then triglycerides are broken down into glycerol which liver can use for gluconeogenesis
Breakdown of proteins results in formation of amino acids which travel to liver. Gluconeogenic amino acids can be used for gluconeogenesis

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4
Q

What happens to fatty acids from lipolysis

A

Travel to liver and are used to make ketone bodies

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5
Q

Ketone bodies normally made from fatty acids

A

Acetoacetate

3-hydroxybutyrate

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6
Q

What effect does insulin deficiency have on ketone body production

A

Insulin would normally inhibit production of Ketone bodies from fatty acyl coA at level of mitochondrial membrane but as there is no insulin ketone body production increases

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7
Q

Why is there metabolic acidosis with diabetic ketoacidosis

A

Reduction in HCO3 as a result of its impaired production and increased H+ buffering

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8
Q

Clinical features of DKA

A

Dehydration
Total body K deficieny but plasma hyperkalaemia
Acidotic
Risk of arrhythmia and infection

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9
Q

Clinical signs of DKA

A
Polyuria and polydipsia
Dehydration
Hyperventilation 
Abdominal pain
Coma
Glycosuria
Ketonuria
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10
Q

How to test for DKA

A

Ketones in the urine

ABG to show metabolic acidosis

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11
Q

Metabolic acidosis ABG

A

Low bicarbonate
Low pH
Low CO2

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12
Q

Treatment of DKA

A

Fluid
Insulin
Potassium
Bicarb

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13
Q

Main effect of insulin deficiency

A

Hyperglycaemia

Ketosis

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14
Q

Main effect of hyperglycaemia

A

Osmotic diuresis

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15
Q

Main effect of ketosis

A

Acidosis

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16
Q

Effects of acidosis

A

Vomiting and hyperventilation

17
Q

Causes of dehydration in DKA

A

Hyperventilation
Osmotic diuresis
Vomiting

18
Q

Main problem with dehydration in DKA

A

Leads to reduced renal perfusion so impaired H+ excretions leading to acidosis