final deck Flashcards
1
Q
Red flags for CAP and severity score
A
RR 22 HR 100 Hypotension sats < 92% acute onset confusion multilobar involvement
C - acute confusion
R - RR 30
B - hypotension
65 years old
2
Q
hypoglycaemia unconscious 8
A
- 1mg glucagon im stat
- 20ml 50% glucose via secure antecubital canula (10% in children)
- 000 stating “diabetes emergency”
- stay with patient until aambulance arrives
- When regains full consciousness and can swallow give oral source of carboydrates
- check BGL 15 minutely until > 4
- Test BGL again 1 hour after emergency to ensure stable glucose levels
- can’t drive for 6 weeks
3
Q
thirst abdo pain polyuria polydipsia nausea and vomiting weight loss moderate - severe dehydration
A
capillary glucose > 15
ketones > 1.5 (or urine ketones moderate to heavy)
-> refer
if child refer if symptoms and BGL elevated
4
Q
Typical symptoms of DKA 5
A
- polyuria
- polydipsia
- abdo pain
- nausea and vomiting
- LOW
5
Q
Classical signs of DKA 5
A
- altered conscious state
- kausmaul breathing
- rapid RR
- dehydration
- ketotic breath
6
Q
classic symptoms of hyperosmolar hyperglycaemic state 4
A
- polyuria
- polydipsia
- abdo pain
- nausea and vomiting
7
Q
classical signs hyperosmolar hypperglycaemic state 2
A
- dehydration
2. nausea and vomiting
8
Q
T2DM on insulin sick day mx
A
- monitor BGLs 2-4 hourly
- have enought needles
- see GP if 2 or more consecutive BGL >15
- may need to increase morning intermediate or long active insulin dose by 10-20%
- if on ultra long acting insulin e.g. degludec seek advice as will take 4-7 days for dose to take effect
- additional blood ketone ttesting may be incorporated if there are symptoms suggestive of ketosis (N&V, SOB, abdo pain, altered consciousness), hx of DKA or using and SGLT2 inhibitor
- May need additional rapid acting insulin to use as a supplemental insulin dose
- If not eating but feel weel and continue usual activities may need to reduce insulin to avoid hypoglycaemia
