Type 1 DM Flashcards
1
Q
2 types of metabolic acidosis
A
- anion gap
2. non-anion
2
Q
DDx for anion gap
A
MUDPILES Methanol Uremia DKA Paraldehyde Isoniazide Lactic acidosis Ethyl Salicylates
3
Q
DDx for non-anion gap (5)
A
- hyperalimentation
- acetozolamide
- Renal tubular acidosis
- Diarhhea
- Sigmoid fistula
4
Q
patho of DKA
A
- no insulin
- increased glucose release from liver
- osmotic diuresis from high glucose
- FFA release from liver converted to ketone bodies
- Ketones cause the gap
5
Q
***diff between T1 and T2 in terms of cause, prevalence, associations, ketoacidosis, pops, age of onset, insulin injections
A
cause- insulin def:insulin insensitive prev- 10%:90 assoc- autoimmunes:metabolic syndromes ketoacidodiss- yes:seldom pops- scanidnavian:aboriginal/asian age- young:old insulin- always:sometimes
6
Q
presentation of T1DM
A
- hyperglycemic osmotic diuresis w/ ECFV contraciton
- anion gap
- beta-hydroxybutrate pos
7
Q
5 main principles***
A
- prevent hypokalemia
- restore ECFV contraction
- correct met. acidosis
- manage hyperosmolarity
- ID precipitating cause
8
Q
what is issue with hypokalemia
A
K deficit in DKA
- giving insulin can cause intracellular shift
- add K to IV
9
Q
**what is major cause of death in DKA
A
hypokalemia
10
Q
**what is mainstay of glucose control in DKA
A
fluids, not insulin
11
Q
what are 2 purposes of IV saline
A
- restore ECFV
2. osmtotic diuresis of glucose
12
Q
how to correct met. acidosis
A
IV insulin
- 0.1 unit/kg IV and then drip
- adjust to level of acidosis, not glucose
13
Q
how to manage hyperosmolarity
A
rapid reduction can lead to cerbral edema, so correct slowly
14
Q
possible precipitating causes
A
- new onset T1DM
- infection
- MI
- inadequate insulin
15
Q
what is phsyiological insulin levels like?
A
boluses after meals and slow release at night as liver releases glucose
