Diabetic Emergencies Flashcards Preview

Hugh's MD2 Gen Med > Diabetic Emergencies > Flashcards

Flashcards in Diabetic Emergencies Deck (12):
1

When do you give bicarbonate in a ketoacidosis?

If the pH <6.8

2

What are some predisposing factors for the development of DKA?

Undiagnosed T1DM

Inappropriate insulin therapy

Alcohol use

Infections - pneumonia

AMI

3

What are the general principles of treatment of DKA?

Rehydration

Treat electrolyte imbalance

Insulin therapy

Search for underlying cause

4

Who are particularly susceptible to getting hypo's?

Elderly with renal impairment on sulfonylureas

5

What must you do before giving insulin in a patient with DKA?

Check the K levels, if <3.5mM hold off

6

What are the defining features of hyperglycaemic hyperosmolar state?

Hyperglycaemia

Limited ketosis or ketoacidosis

Dehydration

Severe osmolarity >330mOsm/kg

Depressed sensorium or coma

7

What is the treatment for HHS?

Fluid resusitation with hypotonic saline - 2L over 1 to 2 hours

Monitor urine output

Insulin

Potassium

Prophylactic heparin

Search for cause

8

What is Kussmaul's breathing?

Deep, laboured breathing that occurs during metabolic acidosis

9

Why does HHS occur?

Relative lack of insulin > hyperglycaemia > polyuria > volume depletion

10

How is hypoglycaemia treated?

Oral sugar if tolerable

IV 50% dextrose 25-50ml

IM glucagon 1mg if no IV

Administer longer acting CHO

11

What is the normal range for potassium?

3.5-5mmol/L

12

Which is a bigger determinant of conscious state, osmolarity or acidosis?

Osmolarity