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M2M Unit III > DKA > Flashcards

DKA Flashcards

1
Q

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

A

beta cells; pancreas

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1
Q

Insulin release is regulated by _____ within the beta cells.

A

a glucose sensing system

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1
Q

Human insulin has a half-life of about _____.

A

5 minutes

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2
Q

Kussmaul respirations

A

deep and rapid respirations

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3
Q

The acidosis seen in DKA is a result of _____.

A

beta oxidation of fatty acids

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3
Q

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

A

sodium

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3
Q

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

A

severe hyperkalemia and severe hypokalemia can lead to death

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4
Q

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

A

osmotic diuresis; hyperglycemia

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5
Q

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

A

aldosterone

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6
Q

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

A

Sodium; potassium

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7
Q

bradycardia

A

slow heart rate

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8
Q

diabetes

A

abnormally high blood sugar

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9
Q

What are the signs and symptoms of cerebral edema?

A

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

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9
Q

mannitol

A

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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11
Q

DKA is defined as _____, _____, and _____.

A

hyperglycemia, metabolic acidosis, ketonemia/ketonuria

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11
Q

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

A

exocytosis

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11
Q

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

A

sodium

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12
Q

hyperkalemia

A

abnormally high K+ in the blood

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14
Q

______ enters the cell through the GLUT2 transporter.

A

Glucose

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15
Q

What causes a drop in the blood pH?

A

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

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15
Q

dextrose

A

a glucose derived from starches

15
Q

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

A

blood glucose concentration; glucose

17
Q

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

A

ATP/ADP; increased

18
Q

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

A

20%

19
Q

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

A

ATP-sensitive K+ channel

20
Q

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

A

1 diabetes mellitus; deficiency

22
Q

Glucose enters the cell through the ______.

A

GLUT2 transporter

22
Q

The increased intracellular calcium ion concentration leads to exocytosis of _____.

A

preformed insulin-containing secretory granules.

23
Q

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

A

glucose; water

24
Q

Most of the body’s ______ is intracellular.

A

potassium

26
Q

acidosis

A

ketone and lactate in the blood

28
Q

What are insulin’s actions on the adipose tissue?

A

Increased glucose uptake, triglyceride uptake, lipid synthesis

29
Q

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

A

0.15-0.3%; ~24%

30
Q

Overly rapid rehydration and hypotonic IV fluids can precipitate _____.

A

cerebral edema

31
Q

What is Cushing’s Triad?

A

hypertension, bradycardia, agonal respirations

33
Q

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

A

depolarizes; calcium influx

34
Q

Treatment for cerebral edema includes ______.

A

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

35
Q

What are insulin’s actions on the muscle?

A

Increased glucose uptake, glycogen synthesis, and protein synthesis

36
Q

The intravenous insulin serves two purposes: _____ and _____.

A

decreasing the blood glucose concentration; halting ketoacid production

38
Q

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

A

Insulin; 51

38
Q

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

A

intracellular potassium; calcium

40
Q

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

A

distal convoluted tubule; cortical collecting duct

42
Q

What are insulin’s actions on the liver?

A

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

43
Q

Two cardinal sins in DKA management are ________ and ______.

A

prematurely stopping the insulin infusion; failing to use enough dextrose

45
Q

_____ release is regulated by a glucose sensing system within the _____.

A

Insulin; beta cells

46
Q

Most of the body’s potassium is ______.

A

intracellular

47
Q

Insulin stimulates uptake of _____ and _____ while promoting synthesis of ____, _____, and _____.

A

glucose; triglycerides; fats, proteins, glycogen

48
Q

The deep and rapid respirations seen in DKA are ____.

A

Kussmaul respirations

49
Q

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

A

respiratory volume; rate

50
Q

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

A

intracellular calcium ion concentration

51
Q

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

A

large volumes of water are lost in the urine

52
Q

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

A

autoimmune; destruction of beta cells

M2M Unit III (30 decks)

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