Pathophys of DKA and Hyperglycemia

Question 1

In diabetic ketoacidosis, the blood sugar level is always over what value?

Answer 1

250mg/dl

Question 2

In Hyperglycemic hyperosmolar syndrome, what is the blood sugar

Answer 2

600mg/dl

Question 3

What is the most common predisposing factor for DKA and HHS?

Answer 3

Infection

• pneumonia
• septicemia
• urosepsis
• abscess
• gastroenteritis

After infection:

• New onset diabetes
• Discontinued Insulin
• Unknown

Question 4

Define gluconeogenesis

Answer 4

The production of glucose from non-carbohydrate precursors

Question 5

THree slides on acute insulin deficiency are gold

Answer 5

look at em

Question 6

Describe what happens to carbohydrate metabolism in Acute Insulin Deficiency

Answer 6

I’ll give you the start point and it is :

1) Insulin deficiency leads to low glucose usage/uptake
2) High blood glucose (hyperglycemia)
3) High glucose in the urine
4) Polyuria
5) loss of fluids and electrolytes
6) Circulatory failure

Question 7

Describe what happens to protein metabolism in Acute Insulin Deficiency

Answer 7

1.) Protein breakdown is increased and protein synthesis is increased.
2) Plasma amino acids rise
3) These amino acids are ammo for gluconeogenesis (the production of glucose from non carb substances) in the liver.
4) Blood glucose goes up
5) polyuria
6) dehydration and electrolytes are gone
7) Circulatory failure
Suck my balls

Question 8

Describe what happens to lipid metabolism in acute insulin deficiency

Answer 8

1) TAGs are converted to FFA
2) Increased ploasma FFA
3) FFAs are oxidized
4) Ketone Bodies formed
5) High plasma ketones
6) Ketonuria
7) Alkaline reserves are mobilized
ACIDOSIS

Question 9

So, describe the pathophysiology of DKA and HHS

Answer 9

1) Some sort of stress (usually infection, but can be something else) causes Insulin deficiency which as we know causes —-> Decreased glucose utilization/uptake
2) Because there is no fucking glucose to use for energy, the counterregulatory hormones like Glucagon, catecholamines, and cortisol have to start mobilizing other energy sources to make glucose.
3) You get Proteolysis leading to gluconeogenesis in the liver, Lipolysis leading to FFAs and ketones, and thats about it.
4) this causes blood sugar to skyrocket even more which leads to dehydration. Also leads to ketones in the blood and acidosis