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Flashcards in 21 - diabetic emergencies Deck (20)
1

what is triad of DKA

1. hyperglycemia
2. ketosis
3. acidosis

2

what type of DM is DKA primarily in

1

3

2 main patho concepts in DKA

1. relative insulin def.
2. counter regulatory hormone excess due to failure of normal mechanisms
- glucagon, catecholamine, cortisol, GH

4

10 causes of DKA

1. lack of insulin
2. infection
3. MI
4. PE
5. stroke
6. pnacreatitis
7. substance abuse
8. meds
9. trauma
10. surg.

5

DKA signs and Sx

DKA
Diuresis, delirium/dizzy, dehydration
Kussmaul breathing, keto breath
Abdo pain

6

3 main goals of DKA Tx

1. restore volume
2. correct lyte imbalance
3. replensh insulin

7

what is fluid replacement

give half amount lost in first 8 hours
- 1-2L NS in first hour
- once glucose falls below 16, change to D5W

8

when to start giving insulin

once K levels reach >3.3 and BP restored

9

how to dose Kcl

based on the levels of K found in the serum

10

role for bicarb in therapy

not one unless pH is

11

big 3 of DKA Tx

1. fluid resus
2. glucose control with insulin
3. correct K

12

what is dreaded outcome in DKA

cerebral edema

13

what defines hyperosmolar hyperglycemic state (HHS)

glucose >33
ph>7.3
bicarb>15
AG320

14

what is key feature to diff DKA and HHS

ketones

15

how are DKA and HHS diff. in presentation

HHS over days to weeks

16

Tx for HHS

same as DKA but no role for bicarb

17

what is whipple's triad in hypoglycemia

1. low plasma glucose
2. Sx suggestive of hypoglycemia
3. prompt resolution when given glucose

18

main causes of hypoglycemia

#1 excessive insulin
- alc., sepsis, liver disease

19

2 classes of Sx in hypo

1. autonomin
- diaphoresis, nausea, hunger, tachy
2. neuroglycopenic
- HA, confusion, seiure, coma

20

Tx of hypo

prehost- glucose fods
in ER - D50 IV