Diabetic ketoacidosis II Flashcards Preview

Module 6: Repro/Endocrine > Diabetic ketoacidosis II > Flashcards

Flashcards in Diabetic ketoacidosis II Deck (9)
1

What are the diagnostic criteria for diabetes mellitus?


- Symptoms of diabetes and a a random glucose >=200mg/dl

OR

- Fasting plasma glucose >= 126 mg/dl

OR

- 2hr plasma glucose >=200mg/dl during an oral glucose tolerance test

OR

- Hemoglobin A1c >= 6.5 (in adults)

 

2


What are clinical features of diabetes mellitus?


Polyuria, Polydypsia, Polyphagia

Nocturnal enuresis

Weight loss

Ketoacidosis: abdominal pain, nausea, vomiting, mental status changes

Fatigue, weakness

blurry vision

Genital yeast infections

3


What is the pathophysiology of T1 DM?


Autoimmune destruction of pancreatic beta cells ( that secrete insulin)

--> Tcell mediated

--> Lymphocytic infiltration

4


What is the Two Hit Hypothesis?

Hypothesis of risk factors for T1 DM


Genetic Susceptibility to diabetes:
- assoc. w/HLA DR3/4, DQ2/8 alleles

Environmental Triggers:
- Viruses: congenital rubella
- Nutritional factors: early exposure to cow's milk and vit D deficiency

5


What are the biochemical criteria for Diabetic Ketoacidosis?


D = Hyperglycemia

K = Ketonemia or ketonuria

A = Venous pH <7.3 or HCO3 < 15mmol/L

6


What is the pathophysiology of Diabetic Ketoacidosis?

7


How is DKA treated?


1. Fluids: Only enough to reverse dehydration and replace ongoing losses (too much can lead to cerebral edema)

2. Insulin: To supress ketosis and reverse acidosis

3. Electrolytes: Replace profound Na and K losses

8


What are signs and symptoms of cerebral edema?


Sudden, persistent drop in HR

Change in sensorium

Headache

Emesis

Incontinence

Unexplained tachypnea

Fall in serum Na or failure to rise

9


What is the prayer sign?


Limited joint mobility due to uncontrolled diabetes

Fingers are unable to fully extend in a prayer position

- Associated with increased risk of retinopathy and nephropathy