DKA Flashcards by Lindsey Herrera

Insulin is a 51 amino acid protein released by the ____ of the _____.

beta cells; pancreas

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Insulin release is regulated by _____ within the beta cells.

a glucose sensing system

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Human insulin has a half-life of about _____.

5 minutes

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Kussmaul respirations

deep and rapid respirations

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The acidosis seen in DKA is a result of _____.

beta oxidation of fatty acids

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As the patient fights dehydration, the body compensates by holding onto ______.

sodium

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K+ management in DKA pts is so important because ______.

severe hyperkalemia and severe hypokalemia can lead to death

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The dehydration seen in DKA is largely the result of the _____ secondary to ______.

osmotic diuresis; hyperglycemia

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Increased sodium conservation in the distal convoluted tubule and cortical collecting duct of the nephron is mediated by _____.

aldosterone

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_____ is retained at the expense of _____ loss in the urine.

Sodium; potassium

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bradycardia

slow heart rate

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diabetes

abnormally high blood sugar

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What are the signs and symptoms of cerebral edema?

mental status changes; headache; Cushing’s triad; fixed, dilated pupils

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mannitol

a sugar alcohol that isn’t metabolized but will raise the osmolality of the blood to pull H2O off the brain

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DKA is defined as _____, _____, and _____.

hyperglycemia, metabolic acidosis, ketonemia/ketonuria

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The increased intracellular calcium ion concentration leads to _____ of preformed insulin-containing secretory granules.

exocytosis

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Increased ______ conservation in the distal convoluted tubule and cortical collecting duct of the nephron is mediated by aldosterone.

sodium

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hyperkalemia

abnormally high K+ in the blood

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______ enters the cell through the GLUT2 transporter.

Glucose

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What causes a drop in the blood pH?

ketones and lactate in the blood that exceeds the amount of HCO3- buffer

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dextrose

a glucose derived from starches

In diabetes the _____ rises above levels which can be reabsorbed through facilitated diffusion and ____ is lost in the urine.

blood glucose concentration; glucose

When the ____ intracellular ratio is _____ in the cell, the ATP-sensitive K+ channel is closed.

ATP/ADP; increased

____ of patients with cerebral edema suffer long term neurologic outcomes.

20%

When the ATP/ADP intracellular ratio is increased in the cell, the _____ is closed.

ATP-sensitive K+ channel

In type \_\_\_\_\_\_, an autoimmune process leads to destruction of beta cells and results in insulin \_\_\_\_\_\_.

1 diabetes mellitus; deficiency

Glucose enters the cell through the \_\_\_\_\_\_.

GLUT2 transporter

The increased intracellular calcium ion concentration leads to exocytosis of \_\_\_\_\_.

preformed insulin-containing secretory granules.

With an excess of _____ in the filtrate, the body is unable to reabsorb as much ____ as it would under normal conditions, leading to polyuria.

glucose; water

Most of the body’s ______ is intracellular.

potassium

acidosis

ketone and lactate in the blood

What are insulin's actions on the adipose tissue?

Increased glucose uptake, triglyceride uptake, lipid synthesis

Cerebral edema, occurring in about _____ of all cases of pediatric DKA, is the leading cause of morbidity and mortality, with a death rate \_\_\_\_.

0.15-0.3%; ~24%

Overly rapid rehydration and hypotonic IV fluids can precipitate \_\_\_\_\_.

cerebral edema

What is Cushing's Triad?

hypertension, bradycardia, agonal respirations

High intracellular potassium _____ the membrane, activating a voltage-gated calcium channel and leading to \_\_\_\_\_.

depolarizes; calcium influx

Treatment for cerebral edema includes \_\_\_\_\_\_.

elevating the head of the bed, hyperventilating the patient, and giving IV mannitol or hypertonic saline

What are insulin's actions on the muscle?

Increased glucose uptake, glycogen synthesis, and protein synthesis

The intravenous insulin serves two purposes: _____ and \_\_\_\_\_.

decreasing the blood glucose concentration; halting ketoacid production

\_\_\_\_ is a ____ amino acid protein released by the beta cells of the pancreas.

Insulin; 51

High ______ depolarizes the membrane, activating a voltage-gated _____ channel and leading to calcium influx.

intracellular potassium; calcium

Increased sodium conservation in the _____ and ______ of the nephron is mediated by aldosterone.

distal convoluted tubule; cortical collecting duct

What are insulin's actions on the liver?

Increased glucose uptake, glycogen synthesis, and lipogenesis Decreased gluconeogenesis, ketogenesis

Two cardinal sins in DKA management are ________ and \_\_\_\_\_\_.

prematurely stopping the insulin infusion; failing to use enough dextrose

\_\_\_\_\_ release is regulated by a glucose sensing system within the \_\_\_\_\_.

Insulin; beta cells

Most of the body’s potassium is \_\_\_\_\_\_.

intracellular

Insulin stimulates uptake of _____ and _____ while promoting synthesis of \_\_\_\_, \_\_\_\_\_, and \_\_\_\_\_.

glucose; triglycerides; fats, proteins, glycogen

The deep and rapid respirations seen in DKA are \_\_\_\_.

Kussmaul respirations

To compensate for the excess acid, the body increases _____ and ____ to hasten the elimination of carbon dioxide.

respiratory volume; rate

The increased ______ leads to exocytosis of preformed insulin-containing secretory granules.

intracellular calcium ion concentration

Because of the high blood glucose concentration, \_\_\_\_\_\_\_, even in the setting of dehydration.

large volumes of water are lost in the urine

In type 1 diabetes mellitus, an _____ process leads to ______ and results in insulin deficiency.

autoimmune; destruction of beta cells