endocrine hyperglycemic crisis

Question 1

explain the pathogenisis of how dka happens

Answer 1

due to stressors such as an acute infection causes there to be an increased metabolic demand on the body(so no insulin) (no insulin may also be due to non compliance) which leads to increased lipolysis( insulin normally prevents lipolysis from happening) which causes increased fatty acids and then incr ketones

Question 2

clinical features of dka

Answer 2

DKA
delirum/psychosis.. dehydration
kusmaul respiration
ABdomen..abd pain, nause and vomitting
acetone breath..fruity breath

Question 3

what happens with potassium in dka

Answer 3

there is decreased intracellular potassium, normal or increased in serum and increased in urine(hyperkaluria)

Question 4

how does dehydration occur with hhs

Answer 4

due to hyperglycemia there is increased osmolality(increased solutes in serum) which leads to osmotic diuresis (increased urine output due to increased solutes in urine) which causes dehydration

Question 5

what are lab features youd expect in hhs with regards to osmolality, glucose, potassium, ph and ketones

Answer 5

serume osmolality greatre than 320
hyperglycemia greatre than 600
decreased intracellular calcium, hyperkaluria
normal ph and ketones

Question 6

what must be ensured before giving insulin to a patient with hyperglycemic crisis

Answer 6

that potassium be over 3.3…insulin causes hypokalemia

if less thn 5.3 then must be given potassium repletion once insulin is being given