DKA and Adrenal Insufficiency Flashcards Preview

ER 1 > DKA and Adrenal Insufficiency > Flashcards

Flashcards in DKA and Adrenal Insufficiency Deck (10)
Loading flashcards...
1
Q

Review of aldosterone physiology

A
  • it take Na and reabsorbs it from urine and puts it back into the blood
  • result of hyperaldosterone =
  • HTN
  • expanded extracellular fluid volume (but no edema)
  • hypokalemia
  • metabolic alkalosis
2
Q

presentation of hypoaldosteronism

A
  • may have hx of recent steroid therapy where adrenal are suppressed from chronic inhibition of pituitary
  • may just have hx of lassitude, fatigue, dizziness upon rising
3
Q

PE in hypoaldosteronism

A
  • evidence of volume contraction
  • positive tilt test
  • possible hyperpigmentation of skin
4
Q

lab results in hypoaldosteronism

A
  • Na: 130
  • K: 6.0
  • Cl: 106
  • HCO3: 18
5
Q

anion gap formula

A

Na - (Cl + HCO3)

cations - anions

6
Q

nl anion gap

A
  • per textbook: 12

- clinically: 12-18

7
Q

classic presentation of DKA

A
  • pt w/ DM type I and have become ill, usu infection, or cannot eat and haven’t taken insulin
  • Type II can also present in rare cases
8
Q

review of insulin physiology

A

-insulin forces glucose into muscle cells and inhibits breakdown of adipose tissue

9
Q

DKA phys review

A
  • when there is a lack of insulin:
  • adipose breaks down and releases FFA into the blood stream
  • the liver takes up the FFA and turns them into ketone bodies
  • glucose can’t be taken up into muscle cells so get hyperglycemic
  • have tremendous urine volume d/t hyperosmolality from the sugar
10
Q

ketones released in DKA

A
  • when ketoacids hit the bloodstream and dissociate, they leave H ion and base:
  • either aceto-acetate or beta-hydroxybuterate
  • this widens the anion gap