DKA, HHS, and Endocrine Emergencies Flashcards

Practice flashcards covering the management and pathophysiology of Diabetic Ketoacidosis (DKA), Hyperglycemic Hyperosmolar State (HHS), Diabetes Insipidus, SIADH, and Thyroid Storm based on lecture transcripts.

According to the lecture, what are the primary risk factors for Metabolic Syndrome?

Central obesity, family history, increased age, sedentary lifestyle, unbalanced diet, sleep apnea, stress, low HDL levels, hypertension, hyperglycemia, and inflammation.

What fasting blood glucose level indicates a high risk for diabetes mellitus?

Above $126\,mg/dL$.

What is the hemoglobin A1c (HgbA1c) goal for maintaining stable blood glucose levels according to the notes?

Keep it under $6\%$.

Which insulin injection site provides the fastest absorption?

The abdomen.

How should unopened insulin be stored?

In the refrigerator.

What are the characteristics of NPH insulin regarding onset and peak?

Expected onset of $1.5$ to $4\,hours$ with a peak of $4$ to $12\,hours$.

What is the correct order for mixing regular and NPH insulin?

1. Inspect vials. 2. Roll NPH vial. 3. Inject air into NPH. 4. Inject air into regular. 5. Withdraw regular (short-acting). 6. Add NPH (intermediate-acting).

What are the diagnostic blood glucose level thresholds for Diabetic Ketoacidosis (DKA) and Hyperglycemic Hyperosmolar State (HHS)?

DKA: $>250\,mg/dL$; HHS: $>600\,mg/dL$.

Describe the respiratory manifestations unique to Diabetic Ketoacidosis (DKA).

Fast shallow respirations known as Kussmaul respirations and hyperventilation to blow off carbon dioxide.

What breath odor is characteristic of Diabetic Ketoacidosis (DKA)?

Fruity breath odor (Acetone odor).

What is the typical age range and onset speed for Hyperglycemic Hyperosmolar State (HHS)?

Gradual onset occurring over several days to weeks, typically in older adults (age older than $65$).

What is the diagnostic threshold for serum osmolality in Hyperglycemic Hyperosmolar State (HHS)?

Greater than $320\,mOsm/kg$.

What electrolyte abnormalities are common in Diabetic Ketoacidosis (DKA) due to polyuria?

Loss of sodium, potassium, and water/dehydration.

Which type of insulin is the only one that can be administered intravenously (IV)?

Regular insulin.

Why is $5\%$ dextrose (D5W) added to the IV solution once blood glucose levels drop below $250\,mg/dL$ (DKA) or $300\,mg/dL$ (HHS)?

To prevent hypoglycemia and cerebral edema by avoiding a rapid drop in blood sugar.

At what rate should blood glucose levels be lowered per hour according to the sources?

$50$ to $70\,mg/dL\,per\,hour$.

What is the difference between Central Diabetes Insipidus (DI) and Nephrogenic Diabetes Insipidus?

Central DI is a deficiency in the secretion of ADH by the pituitary gland; Nephrogenic DI is the resistance of the kidneys to ADH.

What is the expected urine specific gravity for a patient with Diabetes Insipidus (DI)?

Very low, less than $1.005$.

What is the primary medication typically used to manage Diabetes Insipidus (DI)?

Desmopressin ($DDAVP$).

What electrolyte imbalance is the hallmark of Syndrome of Inappropriate Antidiuretic Hormone (SIADH)?

Hyponatremia ($sodium < 135\,mEq/L$) due to excess water retention diluting the blood.

What are the symptoms and vital sign indicators of a Thyroid Storm?

Very high fever ($104-106\,^{\circ}F$), severe tachycardia ($>140\,bpm$), agitation, psychosis, and potentially heart failure.

Which medication blocks the conversion of T4 to T3 during a thyroid storm?

Propylthiouracil ($PTU$) or Methimazole.

Why is it important to rotate the fingertip for blood glucose monitoring?

The side of the fingertip is more vascular and causes less pain when punctured.

What is the Hispanic/Latino population’s rate of end-stage renal disease according to the quiz review?

$27\%$, which is more frequent than other populations.