HHS Flashcards
1
Q
Pathophysiology of HHS
A
Hyperglycaemia results in
1) Raised serum osmolality
2) osmotic diuresis
3) severe dehydration
4) electrolyte deficiencies.
2
Q
In what demographic of patients does HHS normally present?
A
- elderly with type 2 diabetes mellitus (T2DM).
3
Q
What factors can precipitate HHS?
A
intercurrent illness
dementia
sedative drugs
4
Q
Describe the difference in onset between DKA and HHS
A
DKA = hours
HHS = days
5
Q
Clinical signs of HHS
A
- dehydration
- polyuria/polydipsia
- lethargy
- N+V
- altered level of consciousness
- focal neurological deficits
- hyperviscosity (=> VTE risk)
6
Q
What investigation results normally point towards a diagnosis of HHS
A
hypovolaemia
BM >30 mmol/L
Serum osmolarity > 320
Normal ketones
Not acidotic
no significant acidosis
7
Q
Management of HHS
A
- Fast IV 0.9% NaCl
- monitor K+
- insulin should NOT be given unless blood glucose stops falling
- VTE prophylaxis
