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Endocrine > Hyperglycaemia hyperosmolar state > Flashcards

Hyperglycaemia hyperosmolar state Flashcards

1
Q

what is HHS

  1. autoimmune disease. destruction of beta pancreatic cells = no insulin
  2. med emergency hyperglycaemia = osmotic diuresis, dehydration and electrolyte deficiency
  3. med emergency. ketone build up in response to lack of insulin = acidosis
A
  1. med emergency hyperglycaemia = osmotic diuresis, dehydration and electrolyte deficiency
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2
Q

what are 3 cardinal features of HHD

A

osmotic diuresis

severe electrolyte deficiencies

severe dehydration

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3
Q

in which type of diabetes doesn HHS usually present in

A

T2DM

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4
Q

which condition has a higher mortality

DKA or HHS

A

HHS

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5
Q

which diabetic emergency presents over a number of days

DKA or HHS

A

HHS

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6
Q

which medical emergency presents within a number of hours

A

DKA

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7
Q

true/false

HHS typically presents over a number of days and in T2DM patients

A

true

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8
Q

in HHS osmotic diuiresis results in a loss of which electrolytes

A

sodium

potassium

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9
Q

list 3 general features of HHS

A

nausea
vomting
fatigue
lethargy

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10
Q

list 3 neurological features of HHS

A

altered consciousness
headaches
papilloedema
weakness

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11
Q

what complication can arise in HHS as a result of severe volume depletion

A

hyperviscocity of blood

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12
Q

what complications can arise as a result of hyperviscoity of blood in HHS

A

MI
strokes
PE
peripheral arterial thrombosis

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13
Q

what are the 3 diagnostic features in investigations that would indicate HHS

A

hypovolaemia

hyperglycaemia +acidosis/ketonaemia

raised serum osmolality

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14
Q

what are the 3 main goals in management of ‘HHS

A

normalise osmolality

replace fluid and loss electrolytes

correct blood glucose levels

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15
Q

what fluid is used to rehydrate HHS patients and at what is it given in

  1. 0.9% NaCl fast rate
  2. Hartmans slow rate
  3. 0.9% NaCL slow
  4. Hartmans slow rate
A
  1. 0.9% NaCL slow
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16
Q

what is the aim of rehydrating the patient with IV fluids in HHS

  1. replace 100% fluids within 24 hrs
  2. replace 50% fluids in 6 hrs
  3. replace 80% fluids on 12 hrs
  4. replace 50% fluids in 24 hrs
  5. replace 50% fluids in 12 hrs
A
  1. replace 50% fluids in 12 hrs
17
Q

what are the 2 complications that can arise as a result of rapidly changing serum osmolality

A

cardiovascular collapse

central pontine myelinolysis

18
Q

true/false

fluid replacement alone will result in gradual decline in blood glucose and osmolality

A

true

Endocrine (9 decks)

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