Flashcards in Diabetic emergencies Deck (18)
What is diabetic ketoacidosis
disordered metabolic state of absolute or relative insulin deficiency AND an increase in the other hormones like glucagon, adrenaline
What 3 things determine a diagnosis of DKA?
Ketonaemia >3mmol, blood glucose > 11mmol, and bicarbonate
What kind of things can cause DKA?
alcohol/ drug use, infection, non compliance with treatment, newly diagnosed diabetes
What kind of signs/ symptoms are present in DKA?
thirst, polyuria, dehydration, vomiting, kussmauls breathing, abode pain and tenderness, flushing, sepsis/ gastroenteritis
What would the glucose, potassium, sodium, CK and lactate levels be in DKA?
Gl: high, K: high Na: low, CK: high, lactate: high
what are some major complications of DKA?
hypokalaemia, aspiration pneumonia, ARDS, cerebral oedema
How would you treat DKA?
replace fluids, insulin, phosphate, potassium, LMWH
What is the usual treatment for hyperglycaemic hyperosmotic syndrome?
who is affected in HHS?
name 4 risk associations with HHS?
MI/STROKE, sepsis and glucocorticoids and thiazides
What would be the typical biochemistry of HHS?
higher glucose, renal impairment, sodium raised, increase in osmolality,
which type of diabetes is more commonly associated with HHS?
where does lactate originate from?
skeletal muscles, red cells, brain and renal medulla
what is the normal ion gap?
What is type A lactic acidosis
associated with tissue hypoxaemia,
what does type B lactic acidosis occur?
liver disease, diabetes association,
in lactic acidosis, what features would you find?
hyperventilation, confusion, absence of katonaemia, raised phosphate, reduced anion gap