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PHCY 631 - Acute Hyperglycemia Questions with Correct Answers
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PHCY 631 - Acute Hyperglycemia Questions with Correct Answers
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PHCY 631 - Acute Hyperglycemia Questionswith Correct Answers
Hyperglycemia emergency common cause Correct Answer-infection
Hyperglycemia emergency other causes Correct Answer-inadequate
insulin, pancreatitis, MI, meds, severe dehydration
Acute hyper causes Correct Answer-Acute illness, stress, Drugs,
nutrition
Hyperglycemia presentation Correct Answer-nonspecific, can have none
unless severe
DKA Presentation Correct Answer-uncontrolled hyperglycemia,
metabolic acidosis, increase in ketones, mostly T1DM
HHS Presentation Correct Answer-dehydration, hyperglycemia,
hyperosmolarity, absence of acidosis, higher mortality
When to obtain A1c on admission Correct Answer--Patients with known
DM if result is not available in last 2-3 months
-Patients with BG > 140 admitted to hospital if not performed in last 3
months
,Hyperglycemia complications Correct Answer-inhibits function of
WBCs, impairs blood flow
Derangements in BG complications Correct Answer-increase mortality,
ICU acquired weakness
Hyperglycemia/Hypoglycemia compications Correct Answer-increased
mortality in acutely ill patients
hospitalized BG goals Correct Answer-140-180 mg/dL
Sulfonylurea issues in hospital Correct Answer-can lead to
hypoglycemia if nutrition interrupted or AKI
Metformin issues in hospital Correct Answer-CI with decreased renal
blood flow, surgery, ionized dyes
TZDs issues in hospital Correct Answer-long onset, edema, CHF
GLP-1/DDP4i issues in hospital Correct Answer-limited use in patients
not eating, long t1/2
When to stop insulin drip when switching to SubQ Correct Answer-1-2h
after nutritional
OR
, 2-3h after basal
Hypoglycemia tx Correct Answer-d/c insulin, give glucose, monitor till
stable, IV glucagon, D50
DKA & HSS Tx Correct Answer-Fluids, Potassium, Insulin
Can a person with T1DM who manages their insulin with a pump
continue to do so when hospitalized? Explain Correct Answer-Yes
(assuming sugars well controlled w/ pump); often pt can achieve better
control of BG using pump than the medical team could through 4x daily
SUBQ insulin
What is the most common cause for hyperglycemia in the hospital?
Other common causes? Correct Answer-infection; physical
stress/trauma, steroids, thiazides, & atypical antipsychotics
Generally, how do the signs of DKA and HHS typically differ? Correct
Answer-BG usually much higher in DKA; significant metabolic acidosis
& urine ketone present in DKA but not HHS; hyperosmolarity more
likely in HHS than DKA; anion gap more likely to be elevated in DKA
than HHS
For each of the following oral antidiabetics, what is wrong w/ using
them in the hospital setting?
a) metformin
b) sulfonylureas
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