Dka Vs Hhs

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Dka Vs Hyperosmolar Hyperglycemic State (hhs)

Don't miss your chance to win free admissions prep materials! Click here to see a list of raffles . DKA vs Hyperosmolar hyperglycemic state (HHS) why is plasma osmolarity (Posm) always high in HHS, whereas DKA Posm is variable? Pathogenesis of DKA and HHS are discussed in the same article in uptodate but the Posm difference between the 2 is not clearly explained (at least to my feeble mind). The increase in plasma osmolality created by hyperglycemia pulls water out of the cells, expands the ECF, and thereby reduces the plasma sodium (Na) concentration. If a patient with normal serum electrolytes (Na = 140 mEq/L) rapidly developed a glucose concentration of 1000 mg/100 mL, and no urine was made, then that patients serum Na would fall to value between 119 and 126 mEq/L and the osmolality would increase to a level between 294 and 308 mosm/L. However, the osmolality usually increases to a greater degree because a large volume of relatively electrolyte-deficient urine is excreted during the evolution of the hyperglycemic state. The loss of this electrolyte-free water further raises the osmolality . In patients with ketoacidosis, high plasma acetone levels also contribute to the elevate Continue reading >>

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Popular Questions

  1. RedhairedNurse

    Your nursing text should point out the difference. I would tell you, but I'd just have to look it up and my books are in storage. I could also google it, but something you can also do as well. Sorry.

  2. RedhairedNurse


  3. Ilithya

    In HHNS, blood sugar levels rise, and your body tries to get rid of the excess sugar by passing it into your urine, your body tries to compensate. This usually happens to type 2s
    In DKA there is little to no circulating insulin. DKA occurs mainly, but not exclusively, in Type 1 diabetes because Type 1 diabetes is characterized by a lack of insulin production in the pancreas. It is much less common in Type 2 diabetes because the latter is closely related to cell insensitivity to insulin, not -- at least initially -- to a shortage or absence of insulin. Some Type 2 diabetics have lost their own insulin production and must take external insulin; they have some susceptibility to DKA. You get acidosis in DKA because ketones lower the bloods pH.
    Does that help?

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