Hyperglycemia and hypoglycemia Flashcards

1
Q

A postprandial BG level of what is diagnostic of DM?

A

180 mg/dL

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2
Q

What test finding is needed to definitively diagnose DKA?

A

Ketonuria

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3
Q

What is the threshold above which glucosuria develops?

A

180 mg/dL

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4
Q

Neuro s/sx are more prevalent in DKA or HHS?

A

HHS

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5
Q

What neuro s/sx can be seen with DKA /HHS?

A

Seizures
Focal weakness
Lethargy
Coma

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6
Q

What labs/tests, besides a CBC ad BMP, should a pt with suspected DKA/HHS get?

A
ABG
EKG
Phosphorus
Mg
Ketones
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7
Q

Which has higher [BG] DKA or HHS?

A

HHS

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8
Q

Which has an AG acidosis: DKA or HHS?

A

DKA

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9
Q

What is the rate of fluid administration for DKA and HHS (same for both)?

A

15-20 ml/kg/hr

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10
Q

When should the fluids be switched to 0.5 NS in the treatment of both DKA and HHS?

A

When Na normalizes

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11
Q

When should dextrose be added in the treatment of DKA?

A

When BG reaches 250 mg/dL

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12
Q

What should come first in the treatment of DKA/HHS: insulin or fluids?

A

Fluids

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13
Q

What is the rate of insulin infusion in the treatment of DKA?

A

0.1 U/kg/hr

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14
Q

When should insulin therapy be started relative to K replacement?

A

If the initial potassium is less than 3.3 mEq/L then DELAY insulin therapy until fluid and potassium replacement

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15
Q

When is the use of bicarb indicated in the treatment of DKA?

A
  • if pH is less than 6.90
  • Severe life-threatening hyperkalemia
  • Seizures
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16
Q

How often should BG and a BMP be obtained during the treatment of DKA?

A

q2-4 hours

17
Q

What is a major complication of treating DKA/HHS? What are the s/sx that precede this?

A

Cerebral edema

HA, confusion, lethargy

18
Q

What treatments are associated with the development of cerebral edema in treating DKA/HHS?

A

Fluid and bicarb administration

19
Q

What must always be asked when a pt is diagnosed with DKA?

A

Why are they in it? (sepsis? med non-compliance?)

20
Q

What is the definition of hypoglycemia?

A

Less than 50-60 mg/dL

21
Q

What are the two broad categories of symptoms pts have with hypoglycemia?

A

Neuroglycopenia

Hyperepinephrinemic (sympathomimetic)

22
Q

How much oral glucose is given to symptomatic hypoglycemic patients (who are still conscious)?

A

300g (1200 cal)

23
Q

How much IV glucose is given to pts with hypoglycemia?

A

50 ml of 50% D50 or 1 mg/jg in kids

24
Q

What is the dose of glucagon given to hypoglycemic pts?

A

1 mg IM and 0.5 mg IM in peds

25
Q

What additional medication can be given to pts who take sulfonylureas who continue to have hypoglycemia?

A

Octreotide (prevent insulin secretion)