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Flashcards in Diabetes emergencies Deck (17):
1

what is diabetic ketoacidosis?

a disordered metabolic state that usually occurs in the context of an absolute or relative insulin deficiency accompanied by an increase in counter regulatory hormones

2

name some things which can contribute to DKA?

infection
illicit drug use
alcohol
non adherence with treatment
newly diagnosed diabetes

3

what are the typical signs and symptoms of DKA?

thirst
polyuria
dehydration

4

name some ketone related signs and symptoms of DKA

abdo pain
nausea
vomiting
breathless- Kaussmaul's breathing
flushed

5

at presentation is sodium high or low? (DKA)

low

6

at presentation is creatinine high or low?(DKA)

high

7

at presentation is lactate high or low(DKA)

usually high

8

how do you manage and treat DKA?

IV fluids
insulin
potassium (rarely)
bicarbonate (only in severe cases)

9

what are the typical features of hyperglycaemic hyperosmolar syndrome (HHS)?

diabetes may be known
usually older patients
high refined CHO intake pre event
risk associations- stroke/MI, sepsis, glucocorticoids, thiazides

10

is sodium high or low on admission of HHS?

high

11

what usually has higher glucose levels-DKA or HHS?

HHS

12

what is normal lactate range?

0.6-1.2mmol/L

13

what is the normal range of ion gap?

10-18 mmol/L

14

what is type A lactic acidosis associated with?

tissue hypoxaemia. e,g infarcted tissue in bowel ischaemia

15

what is type B lactic acidosis associated with?

liver disease
leukaemic disease
diabetes

16

what might this be?
hyperventilation
mental confusion
stupor or coma if severe
reduced bicarb
raised ion gap
raised phosphate

lactic acidosis

17

how do you treat lactic acidosis?

fluids
antibiotics