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Flashcards in Diabetic Ketoacidosis Deck (13)
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rising levels of plasma glucose case

osmotic diuresis-->decrease in ECV

1

body responds to stress of decreased EVC

increasing epinephrine, cortisol, and GH-->block insulin -->further decrease insuline ffects

2

because insulin is so low

glucagon is unopposed-->mobilize stores!-->increase glucose, muscle breakdown into alanine, fat lipolysis into free fatt acids

3

how do ketoacids form

increase hormone sensitive lipase-->release of FFA into circulation-->enter cells-->some metabolized to ATP by mito-->eventually NAD overwhlmed and FFA are used to make ketones (beta hydroxubutryase and acetoacetate)-->buffered-->overwhelm buffers->ketoacidosis

4

charactersitc, but w/ unclear cause, complications

abdominal pain

5

tx of diabetic coma

replete volume!
metabolic control via high dose insulin

6

how do you know when youre out of the water

normal anion gap

7

why is restoring volume important

restore bp-->decrease epi levels!
decrease osmolarity

8

lipolysis is

slow! (and this is fueling acidosis)--24 hrs of continuous insulint herapy

9

insulin wont bind well to receptor until

epi is down (volume repleated)

10

once acidosis clears, you need

K+ repletion (because K will plummet! by going into cells)

11

what breaks down into ketoacids

acetyl coa (has nowhere to go)

12

HONK usually happens

in people over 70 with limited self-care capability that have glucose over 1000 and lose 10-15 L of water (type 2 DM)