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Endocrine Wk4 part 2 Questions and answers 2024
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Endocrine Wk4 part 2 Questions and answers 2024
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Endocrine Wk4 part 2Common triggers for Hyperosmolar Hyperglycemic State?
Cocaine, dehydration, acute illness (MI,pneumonia)and poor adherence
to DM medications
Patients with HHS tend to have neurologic symptoms because
_____causes water to leave the brain.
high serum osmolarity
The major risk factors for HHS are
uncontrolled type 2 DM and advanced age.
counterregulatory hormones such as _____, increase blood sugar levels
by accelerating gluconeogenesis and glycogenolysis and decreasing
glucose utilization by tissues.
catecholamines, cortisol, glucagon, and GH
Although the stress response is an adaptive mechanism b/c muscles
need glucose for fight or flight, in HHS blood sugars ____
spike uncontrollably, often exceeding 1000 mg/dL (normal <100mg/dL)
In HHS, ___ & __ are lost in urine--> ___&__
sodium and potassium; volume depletion & low total body potassium
IN HHS potassium shifts ___
out of cells into body -->hyperkalemia; reduced insulin makes Na/K/ATP
pump less active --> raising Potassium level in the blood.
why doesn't HHS cause ketones in the blood, like DKA does?
, ype 2 DM, cells are resistant to insulin, but the pancreas may still make
insulin. Even a small amount of insulin is enough to suppress lipolysis
(free fatty acid production) and the subsequent ketone formation that
characterizes DKA
What confirm Dx of HHS
a blood glucose level >600 mg/dL, serum osmolarity >320 mOsm/L
(normal is 270-290), and the absence of ketoacidosis; hyponatremia;
hypokalemia(total body) elevated BUN/Creatinine--> prerenal acute
kidny injury
HHS Tx
saline, insulin, potassium (if <5.3)
Risk factors for DKA, the 5 Is
Infection, Infarction, Insulinopenia, Iatrogenic causes (eg, medications),
and Infant related (eg, pregnancy)
Glucagon mediated glycogen breakdown in muscle --> release of
both lactic acid, which contributes to acidosis, and prostaglandins, which
may play a role in abdominal pain and other symptoms.
Name the ketone bodies
acetoacetate and β-hydroxybutyrate,
What causes the high anion gap in DKA?
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