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Flashcards in DKA PBL Deck (40):
1

Normal ABG pH:

7.35-7.45

2

Normal ABG pCO2:

35-45 mmHg

3

Kussmaul respirations indicate?

Blowing off CO2

caused by high H+ (low pH), acidosis

4

How is anion gap calculated?

([Na+] - ([Cl-] + [HCO3-])

+'s minus -'s

5

Normal anion gap?

8-12

6

high anion gap = ?

acidosis

7

low anion gap = ?

Multiple Myeloma

8

What is the Tm of SGLT-2's?

15 mM glucose ---> glucosuria

9

What drives K into cells via stimulation of Na-K-ATPase?

insulin

10

How does acidosis affect K transport and regulation?

HCO3 gets used up by excess H+ in serum

Extra H+ is pumped into cells and K+ gets kicked out

creating hyperkalemia

11

Why does K leave cells in hyperglycemia?

solvent drag

higher extracellular osmolality due to inc gluc draws water out and K in cell (which is high to begin with) follows through aquaporins

12

Why does K need to be monitors so carefully when correcting acidosis?

Intracellular hypokalemia exists despite serum hyperkalemia.

13

What do ketones in the urine have to do with excretion of K?

Ketones bind Na and K and are excreted as salts

14

What is the insulin dependent glucose transporter on skeletal and adipose tissue?

GLUT4

15

Lispro

Rapid acting insulin

16

Aspart

Rapid acting insulin

17

Glulisine

Rapid acting insulin

18

Onset time for rapid acting insulin?

0.25 hours

15 min

19

Peak time for rapid acting insulin?

0.5-1.5 hours

20

Duration of rapid acting insulin?

3-4 hours

21

Onset time for short acting insulin?

0.5 hours

30 min

22

Peak time for short acting insulin?

2-3 hours

23

Duration of short acting insulin?

4-8 hours

24

Onset time for intermediate acting insulin?

2-4 hours

25

Peak time for intermediate acting insulin?

4-12 hours

26

Duration of intermediate acting insulin?

10-20 hours

27

Onset time for Long acting insulin?

1-2 hours

28

Peak time for long acting insulin?

none --- relatively flat

29

Duration for long acting insulin?

18-24 hours

30

"Regular" insulin

short acting

IV tx to correct DKA

31

NPH

neutral protamine Hagerdorn or isophane

intermediate acting insulin

32

glargine

long acting insulin

33

detemir

long acting insulin

34

Sx of DKA:

polyuria

polydypsia

polyphagia

fatigue

dyspnea (Kussmaul respirations)

abd pain

N/V

HA

confusion

lethargy

35

Goal A1C fro diabetics:

36

Genes associated with Type I DM?

HLA-DR3
HLA-DR4

37

Insulin receptor type?

growth factor R family (span membrane once)

tyrosine kinase activators

38

Metabolic pathway of insulin signaling?

PI3-kinase --> serine/threonine kinase Akt --> GLUT4 vesicles to membrane

**increase glycogen and lipid synthesis
**stimulates protein synthesis via mTor

39

Mitogenic pathway of insulin signaling?

Ras --> phosphorylation cascade via MAP kinase --> cell growth and proliferation

40

Insulin increases a lot of stuff. What does it decrease?

glucagon release