DKA Flashcards

1
Q

what is DKA caused by?

A

relative or absolute lack of insulin

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2
Q

Decreased insulin results in release of stress hormones . name them?

A
  • Adrenaline
  • Cortisol
  • Glucagon
  • Growth hormone
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3
Q

Can DKA occur in type 2?

A

yes, just more rare

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4
Q

Normally, when are keto acids produced?

A

the liver produces keto acids from the deamination of amino acids, for energy

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5
Q

when do you get abnormal build up of ket acids?

A

Body has perceived low glucose. Keto acids are produced through metabolism of fatty acids in liver. There is increased delivery of fatty acids to liver

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6
Q

Main source of energy for body when perceived lack of glucose?

A

free fatty acids

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7
Q

The substance you can smell on someones breath?

A

acetone, a breakdown of one of the keto acids produced (acetoacetic acid)

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8
Q

In established type 1 d, there will usually be a precipitating factor. Name four precipitating factors

A
  • Infection
  • Alcohol or illicit drug use (Anna c)
  • Non adherence with treatment
  • Newly diagnosed
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9
Q

is coma common in hyperglycaemia?

A

NO

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10
Q

what is the SOB in DKA called?

A

Kussmauls respiration

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11
Q

what is the normal glucose level?

A

over 40

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12
Q

potassium?

A

normally raised

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13
Q

why is potassium raised?

A

Potassium is taken up into cells along with insulin. With a lack of insulin, extracellular potassium rises and intracellular potassium falls.

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14
Q

get lactate from muscle, where else?

A

from red cells,skeletal muscle, brain and renal medulla

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15
Q

Clearance of lactate requires?

A

hepatic uptake and aerobic conversion to pyruvate then glucose

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16
Q

Treatment of DKA?

A

IV fluids for dehydration
potassium
Insulin infusion (based on weight)

17
Q

what do people die of in DKA?

A

Hypokalaemia
Aspiration pneumonia
ARDS

18
Q

Blood ketones are usually ? in DKA

A

over 5

19
Q

What is potassium level usually like in DKA?

A

raised

20
Q

clinical features ?

A
Polyuria, thirst
Weight loss
Weakness
Nausea / vomiting
Leg cramps
Blurred vision
Abdominal pain
Kussmaul breathing
Dehydration
Hypotension
Cold extremities / peripheral cyanosis
Tachycardia
Hypothermia
Smell of acetone
Confusion / drowsiness / coma