DKA

Question 1

What is an anion gap? What are the normal values?

Answer 1

Na - (Cl + HCO3)

8-12mEq/L

Question 2

What does an elevated ion gap mean?

Answer 2

There is a metabolic acidosis…there could also be a mix

Question 3

What is the acronym for ddx of elevated anion gap acidosis?

Answer 3

MUDPILES

Question 4

What does the ‘M’ in ‘MUDPILES’ stand for?

Answer 4

Methanol (formic acid)

Question 5

What does the ‘U’ in ‘MUDPILES’ stand for?

Answer 5

Uremia

Question 6

What does the ‘D’ in ‘MUDPILES’ stand for?

Answer 6

DKA

Question 7

What does the ‘P’ in ‘MUDPILES’ stand for?

Answer 7

Propylene Glycol…usually dyed pink and usually safeish

Question 8

What does the ‘I’ in ‘MUDPILES’ stand for?

Answer 8

Iron tablets; Or

Isoniazid…TB treatment

Question 9

What does the ‘L’ in ‘MUDPILES’ stand for?

Answer 9

Lactic Acidosis

Question 10

What does the ‘E’ in ‘MUDPILES’ stand for?

Answer 10

Ethylene Glycol (oxalic acid)…antifreeze

Question 11

What does the ‘S’ in ‘MUDPILES’ stand for?

Answer 11

Salicylates (late)…aspirin

Question 12

What is the acronym for normal anion gap acidosis conditions (conditions with a low delta gap)?

Answer 12

HARD-ASS

Question 13

What does the ‘H’ in ‘HARD-ASS’ stand for?

Answer 13

Hyperalimentation (TPN)

Question 14

What does the first ‘A’ in ‘HARD-ASS’ stand for?

Answer 14

Addison’s Dx…chronic adrenal insufficiency

Question 15

What does the ‘R’ in ‘HARD-ASS’ stand for?

Answer 15

Renal Tubular Acidosis

Question 16

What does the ‘D’ in ‘HARD-ASS’ stand for?

Answer 16

Diarrhea

Question 17

What does the second ‘A’ in ‘HARD-ASS’ stand for?

Answer 17

Acetazolamide…Carbonic Anhydrase inhibitor

Question 18

What does the first ‘S’ in ‘HARD-ASS’ stand for?

Answer 18

Spironolactone…aldosterone antagonist; other hormone antagonists

Question 19

What does the second ‘S’ in ‘HARD-ASS’ stand for?

Answer 19

Saline infusion

Question 20

What kind of receptor is the insulin receptor?

Answer 20

Tyrosine Kinase Receptor–>increases IP-3

Question 21

Where are each of the GLUT transporters?

Answer 21

1- RBCs and barrier tissues (BBB)
2- Hepatocytes; beta-cells
3- Brain; neurons
4- Fat; striated muscles

Question 22

What are rapid-acting insulin medications?

Answer 22

Insulin aspart (NovoLog)
Insulin glulisine (Apidra)
Insulin lispro (Humalog)

Question 23

What is the onset of rapid-acting insulin medications?

Answer 23

15 minutes

Question 24

When is the peak effect of rapid-acting insulin medications?

Answer 24

30-90 minutes

Question 25

What is the duration of rapid-acting insulin medications?

Answer 25

3-5 hours

Question 26

What is a short-acting insulin medication?

Answer 26

Insulin regular

Question 27

What is the onset of short-acting insulin medications?

Answer 27

30-60 minutes

Question 28

When is the peak effect of short-acting insulin medications?

Answer 28

2-4 hours...would hypothetically peak as rapid-acting was diminishing

Question 29

What is the duration of short-acting insulin medications?

Answer 29

5-8 hours

Question 30

What are intermediate-acting insulin medications?

Answer 30

Insulin NPH human

Question 31

What is the onset of intermediate-acting insulin medications?

Answer 31

1-3 hours

Question 32

When is the peak effect of intermediate-acting insulin medications?

Answer 32

8 hours...would hypothetically peak as intermediate acting was diminished

Question 33

What is the duration of intermediate acting insulin medications?

Answer 33

12-16 hours

Question 34

What are examples of long-acting insulin medications?

Answer 34

``` Insulin glargine (Lantus) Insulin determir (Levemir) ```