DKA vs HHS

Question 1

In HHS, blood becomes hyperosmolar causing what?

Answer 1

intracellular fluid to move out of the cells into the extracellular space.

Question 2

in HHS, what major intracellular electrolyte is also pulled out of the cells into the ICF?

what does this lead to?

Answer 2

potassium

potassium imbalance

Question 3

in HHS, cells are not absorbing what?
what does this lead to?

Answer 3

glucose

leads to glycogen breakdown and gluconeogenesis activation

Question 4

in HHS, what is expected of blood glucose?

Answer 4

significant rise in blood glucose levels, typically over 500-600 mg/dL or higher

key characteristic of HHS is severe hyperglycemia (>600)

Question 5

HHS is only seen in what?

Answer 5

type 2 diabetes

Question 6

dehydration in HHS is caused by what?

Answer 6

insulin resistance

Question 7

are there ketones in HHS?

Answer 7

no

Question 8

is HHS gradual?

Answer 8

yes can develop over several days to weeks

Question 9

can illness cause both DKA and HHS?

Answer 9

yes HHS can be caused by infection and DKA can be caused by infection/illness

Question 10

lack of insulin is one of the causes of which disorder?

Answer 10

DKA

Question 11

which has disorientation/confusion?

Answer 11

HHS

DKA has changes in LOC (confusion to unconsciousness)

Question 12

substance abuse is one of the causes of which disorder?

Answer 12

HHS

Question 13

is poor compliance or undiagnosed diabetes a cause of both disorders?

Answer 13

yes

Question 14

which has polyuria?

Answer 14

both

Question 15

which has polydipsia?

Answer 15

both

Question 16

which has polyphagia?

Answer 16

DKA

Question 17

which has hypotension?

Answer 17

HHS Sx

DKA Sx but when caused by extreme dehydration (shock response)

Question 18

which has profound dehydration?

Answer 18

both

Question 19

which has weight loss?

Answer 19

DKA

Question 20

which has abdominal pain?

Answer 20

DKA

Question 21

which has a rapid thready pulse?

Answer 21

HHS

Question 22

which has tachycardia?

Answer 22

DKA Sx but when caused by extreme dehydration (shock response)

Question 23

which has severe N/V?
what does this lead to?

Answer 23

DKA

ketosis

Question 24

which can have seizures and coma?

Answer 24

HHS

Question 25

what is expected of glucose in DKA?

Answer 25

> 250

Question 26

DKA is a hyperglycemic emergency caused by what?

Answer 26

​Markedly decreased or absence in the amount of insulin​

Question 27

what diabetes is DKA seen in?

Answer 27

​Typically seen in Type 1 DM, but can occur in Type 2 ​

Question 28

DKA may be the initial presentation of what?

Answer 28

type 1 diabetes

Question 29

which has metabolic acidosis?

Answer 29

DKA

Question 30

what age does DKA happen typically?

Answer 30

​Occurs most often in younger people, but can happen at any age.​

Question 31

do both DKA and HHS have electrolyte loss?

Answer 31

yes

Question 32

DKA results from the development of what?

Answer 32

ketosis

Question 33

which has acetone breath & kussmaul resps?

Answer 33

DKA

Question 34

what is given FIRST for both DKA and HHS?

Answer 34

hydration!

Question 35

what fluids are given for HHS?

Answer 35

IV fluid like normal saline

Question 36

why do we give IV fluids for HHS?

Answer 36

to correct dehydration and restore electrolyte balance

Question 37

In HHS, rehydration helps move ______ back into the cells and corrects ______ imbalances.

Answer 37

glucose; potassium

Question 38

fluid is given for DKA to restore _________ volume, clear ______, and correct _______ ______

Answer 38

To restore intravascular volume​ To clear ketones​ To correct electrolyte imbalances​

Question 39

what is given after hydration for both HHS and DKA?

Answer 39

insulin

Question 40

for HHS, regular insulin is administered after rehydration to do what?

Answer 40

lower blood glucose levels Insulin helps regulate glucose and prevent further complications, **but hydration must come first to stabilize the patient.**

Question 41

what insulin is given in DKA and until when?

Answer 41

IV insulin until blood glucose is < 250. Then switched to SQ insulin.​

Question 42

why do we want to administer the IV insulin slowly in DKA?

Answer 42

to avoid rapid fluid shifts

Question 43

what is the goal with insulin tx in DKA?

Answer 43

gradual blood sugar reduction to avoid hypoglycemia

Question 44

for both, rehydration and insulin therapy shifts potassium back into cells, possibly leading to what?

Answer 44

hypokalemia

Question 45

In HHS what complications come from insulin & rehydration?

Answer 45

hypokalemia & hypomagnesemia

Question 46

during tx, for which do we need to monitor for cerebral edema as fluid shifts back into the cells?

Answer 46

DKA

Question 47

In DKA, what are the most common electrolyte imbalances BEFORE treatment?

Answer 47

hyponatremia & hyperkalemia

Question 48

List complications of DKA (4)

Answer 48

rapid fluid shifts hypoglycemia hypokalemia hyponatremia