Clinical - DMT1 Flashcards
What is skin turgor?
Skin tenting - dehydration
Skin with decreased turgor remains elevated after being pulled up and released
What kind of breath is expected in patients with ketoacidosis?
fruity
What are the breathing patterns of diabetic ketoacidotic pts?
Kussmaul
What can cause kussmaul breathing?
K = ketones U= Uremia S=Sepsis S = salicylates M = Methanol A = Aldehydes U L = Lactic acid
What are signs of DKA?
Kussmaul Acetone breath Dry mucous membranes Poor skin turgor Tachycardia Hypotension Fever Abdominal tenderness
What is the expected lab results of DKA pt?
hyperglycemia Ketosis Metabolic acidosis Anion gap Increase K possible because decrease of pH Hypertriglyceridemia Hyperlipoproteinemia Hyperamylasemia: salivary or acute pancreatitis Leukocytosis
What can cause high anion gap acidosis ?
M - methanol U - Uremia D - Diabetic ketoacidosis P - paraldehyde I - Isopropyl Alcohol, Iron, INH L - Lactic acidosis E - Ethylene Glycol S - Salicylates
What are the most likely predisposing factors for DKA?
Previously undiagnosed diabetes
Infection
Systemic illness
Dehydration
What are features that are shared by both Type 1 and Type 2 DM?
Dehydration
Insulin deficiency - either absolute or relative
Glucagon excess - either absolute or relative
What is the etiology of DKA?
Inadequate insulin
Infection
Surgery
Drugs like cocaine
What are the initial symptoms of DKA?
Anorexia Nausea Vomiting Polyuria Thirst
What are the progressive symptoms of DKA?
Abdominal pain
Altered mental function
Coma
How do you calculate anion gap?
= [Na] - ([Cl]+[HCO3])
What are the differential diagnosis for mental status changes
AEIOU TIPS Alcohol/Acidosis Epilepsy/Endocrine/Exocrine/Encephalopathy Infection Opioid/Overdose Uremia
Trauma
Insulin
Psychosis
Syncope/Stroke
