5: Diabetes emergency and high glucose states Flashcards Preview

Endocrine Week 2 2017/18 > 5: Diabetes emergency and high glucose states > Flashcards

Flashcards in 5: Diabetes emergency and high glucose states Deck (33)
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1

Can DKA occur in T1 and T2 diabetes?

Yes

but it's far more common in Type 1 diabetics

2

How is DKA diagnosed?

Ketonaemia - blood ketone levels > 3mmol/L

Blood glucose conc. > 11.0mmol/L

Bicarbonate levels < 15mmol/L

pH < 7.3

3

What name is given to DKA in which blood glucose levels are normal?

Euglycaemic DKA

4

What commonly triggers DKA?

Infection

Alcohol and drugs

Insulin non-adherence

New diagnosis of diabetes

5

What are the symptoms of DKA?

Thirst

Polyuria

Flushed

Vomiting

Abdominal pain

Kussmaul's respiration +/- ketone smell

6

What infections commonly cause DKA?

Sepsis (systemic)

Gastroenteritis

7

Although blood glucose > 11.1 mmol/L is diagnostic of DKA, what is the average level found in DKA patients?

40 mmol/L

8

Which electrolyte is raised in DKA?

Potassium

9

What complication of insulin treatment can occur in patients with low-normal potassium?

Hypokalaemia

10

What blood ketone level is diagnostic of DKA?

> 3.0 mmol/L

11

Which ketones are detected in the

a) blood

b) urine?

a) Blood - beta hydroxybutarate

b) Urine - acetoacetate

12

People with T1 diabetes are more likely to have other ___ diseases.

autoimmune

13

High levels of what are lost in DKA?

Fluid

Electrolytes - sodium, potassium, phosphate

14

What neuro complication of DKA is often fatal?

Cerebral oedema

15

What is a respiratory complication of DKA?

ARDS

16

What is an acute complication of DKA which can lead to aspiration?

Gastric dilatation

17

Where are people with DKA supposed to be placed after admission?

HDU

18

How is acute DKA managed?

Fluid replacement

Glucose, insulin, potassium

19

What should be monitored regularly in diabetes patients apart from glucose?

Ketone levels

through blood or urine

20

What complication of diabetes commonly occurs in the older population and is characterised by hyperglycaemia, hypovolaemia and hyperosmolality?

Hyperglycaemic hyperosmolar syndrome

21

Which drugs are strongly linked to HHS?

Steroids

22

What is a rough method of calculating osmolality?

Serum osmolality = 2[Na+ + K+] + Glucose + Urea

23

What is lactic acid a byproduct of?

Anaerobic respiration i.e anaerobic metabolism of glucose

24

What is the normal range of lactate concentrations?

0.6 - 1.2 mmol/L

25

What can lactate concentration reach during intense exercise?

10 mmol/L

26

Are hyperlactataemia and lactic acidosis the same thing?

No, patient can have hyperlactataemia without being in lactic acidosis

27

Lactic acidosis is more likely when a patient's lactate concentration is > _ mmol/L.

> 5 mmol/L

28

Type A lactic acidosis is associated with ___ - infarction, cardiogenic and hypovolaemic shock.

Type B lactic acidosis is associated with liver ___, leukaemia and diabetes.

Type A - hypoxia

Type B - liver damage, leukaemia, diabetes

29

Which drug, used to treat diabetes, is associated with lactic acidosis?

Metformin

30

What are the symptoms of lactic acidosis?

Hyperventilation

Confusion, stupor