ENDOCRINOLOGY

Question 1

INSULIN-DEXTROSE INFUSION

INDICATIONS

Answer 1

T1DM
INSULIN-REQUIRING T2DM
UNSTABLE BGLS
HYPERGLYCAEMIA
MAJOR SURGERY
PROLONGED PERIOD OF NBM POST-OPERATION

Question 2

CONSCIOUS PATIENT WITH HYPO

MANAGEMENT

Answer 2

1. 15 G QUICK-ACTING CARB
2. RECHECK BGL IN 15 MINS AND REPEAT STEP 1 UNTIL BGL > 4 MMOL/L
3. MEAL WITH USUAL RAPID-ACTING INSULIN (IF NO MEAL DUE, GIVE 15-30 G LONGER-ACTING CARB; IF NBM, IV GLUCOSE BOLUS, THEN IV GLUCOSE INFUSION OR IV INSULIN-DEXTROSE INFUSION)
4. RECHECK BGL WITHIN 2 HRS

Question 3

UNCONSCIOUS PATIENT WITH HYPO

MANAGEMENT

Answer 3

1. 50% IV GLUCOSE 25-50 ML OR IM GLUCAGON IF NO IV ACCESS
2. 30 G LONG-ACTING CARB WHEN AWAKE
3. RECHECK BGL HOURLY UNTIL STABLE

Question 4

GLUCOSE CONTROL

IDEAL BGL RANGE DURING ADMISSION

Answer 4

5-10 MMOL/L

Question 5

TYPES OF INSULIN

ULTRA SHORT-ACTING

Answer 5

NOVORAPID
HUMALOG
APIDRA

Question 6

TYPES OF INSULIN

SHORT-ACTING

Answer 6

ACTRAPID

INSULIN R

Question 7

TYPES OF INSULIN

INTERMEDIATE-ACTING

Answer 7

HUMULIN NPH
PROTOPHANE
LEVEMIR

Question 8

TYPES OF INSULIN

LONG-ACTING

Answer 8

LANTUS

Question 9

TYPES OF INSULIN

PRE-MIXED

Answer 9

NOVOMIX-30
HUMALOGMIX25
HUMALOGMIX50
MIXTARD 30/70
HUMULIN 30/70

Question 10

INSULIN-DEXTROSE INFUSION

INDICATIONS

Answer 10

PATIENTS WITH DIABETES WHO ARE NBM PRE-OPERATION OR UNABLE TO TOLERATE ORAL INTAKE
MANAGEMENT OF HYPERGLYCAEMIA OR UNSTABLE BGL

Question 11

INSULIN-DEXTROSE INFUSION

ORDER

Answer 11

50 U OF ACTRAPID IN 49.5 ML OF NS USING A SYRINGE PUMP

125 ML/HR OF 5% IV GLUCOSE

Question 12

INSULIN-DEXTROSE INFUSION AND BGL < 4 MMOL/L

MANAGEMENT

Answer 12

REDUCE INFUSION RATE TO LOWEST RATE
GIVE STAT DOSE OF 100 ML OF 10% IV GLUCOSE OR 20 ML OF 50% IV GLUCOSE
IF SEMI-COMATOSE, BLS AND CALL MET