Dka Vs Hhs Labs

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Free Unfinished Flashcards About Dka & Hhs

1) infection; 2) D/C Meds or inadequate therapy3) trauma; 4) med/surg illnesses -Polyuria-polydypsia-polyphagia with weight loss-Weakness-N/V-A-pain So what are you critically thinking about when you first lay eyes on the patient ? -always think airway.-Breath smells fruity odor so when your burning ketones, you know the pt is diabetic. -CENTRAL-RESPIRATORY-MUSCLUAR-INTESTINAL-RESPIRATORY (SOB, coughing)-HEART (^HR, Arrythmias)-GAStric (NV) Pathophysiology - DKA1. Loss of insulin dependent glucose transport into?2. Increased in liver?3. Increased breakdown of?4. Hyperglycemia- BG >?5. _ketone___/____6. Acidosis pH <_____________?7. HCO3 <_____________ Pathophysiology - DKA1. peripheral tissues2. gluconeogenesis3. fat, protein, and glycogen4. 200mg/dL5. Ketonemia/ketonuria6. pH < 7.3 7. <15 Hyperglycemia:1. above renal threshhold: > ________2. > 180-200 BG is_______________3. Osmotic diuresis drags solutes (Na, K, Cl, PO4) with it leading to loss of ---------> Hyperglycemia1. > 180-200 2. glycosUria3. Dehyration & Electrolyte loss Dehydration:1. aggrivates existing______________2. Lactic ________ Dehydration:1. ketoacidosis2. lactic acidosis HHS:1. Altered sensorium without _______ Continue reading >>

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  1. coreycorndog

    I posted to r/askscience for the hell of it but really this answer is all I needed.

  2. tinkan

    I think it's a pretty straight-forward yes. There is no other energy source other than stored fat and metabolic processes are conserved amongst all animals. The bear must rely on metabolizing the fat stores and that will involve ketosis (the brain likes ketones, it doesn't/can't use FFA - this is why people say the brain prefers glucose but it's really a misnomer. There are no lipid stores in the brain and free fatty acids are not soluble enough in the blood nor are they going to be able to cross the blood brain barrier. This physical barrier means brain cells can not rely on FFA for energy. Thus, FFA are converted in a more blood soluble fat energy molecule, the ketone. In short, the brain does not "require" glucose to function. It just needs time to adapt to ketone usage.)
    Just be forewarned AskScience harbors some anti-keto sentiments that we know to be false (such as loving to bring up the ketoacidosis reason or kidney troubles). But they would probably give you a better answer than us.

  3. Sporkfortuna

    IIRC, Bear recycles his urine during the long winter months.
    "Stuck in a cave, better..."

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Hyperosmolar Hyperglycemic State (hhs)

By Erika F. Brutsaert, MD, Assistant Professor, Albert Einstein College of Medicine; Attending Physician, Montefiore Medical Center Hyperosmolar hyperglycemic state is a metabolic complication of diabetes mellitus (DM) characterized by severe hyperglycemia, extreme dehydration, hyperosmolar plasma, and altered consciousness. It most often occurs in type 2 DM, often in the setting of physiologic stress. HHS is diagnosed by severe hyperglycemia and plasma hyperosmolality and absence of significant ketosis. Treatment is IV saline solution and insulin. Complications include coma, seizures, and death. Hyperosmolar hyperglycemic state (HHSpreviously referred to as hyperglycemic hyperosmolar nonketotic coma [HHNK] and nonketotic hyperosmolar syndrome) is a complication of type 2 diabetes mellitus and has an estimated mortality rate of up to20%, which is significantly higher than the mortality for diabetic ketoacidosis (currently < 1%). It usually develops after a period of symptomatic hyperglycemia in which fluid intake is inadequate to prevent extreme dehydration due to the hyperglycemia-induced osmotic diuresis. Acute infections and other medical conditions Drugs that impair glucose to Continue reading >>

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  1. elsilrac

    hi! im new to IP, starting 4th week today. although things aren't going as quickly as i'd hoped (total lost = 7.2 lbs) its better than where i was 3 weeks ago!
    anywooo, in the past couple days i've developed facial flushing. for no apparent reason my face will become red and warm/hot. when i was lurking around here reading i found out that IP can affect hormones in us. could this flushing be hormonally related which in turn is related to IP??

  2. coliep

    Is there any chance you are getting too many carbs? Now, I have no idea if there is a real basis for this or its just my own questionable theory, but I have noticed that I have something akin to hot flashes when I have consumed a combination of things that is higher in carbs. I have had weird bouts of being cold (which is part of ketosis I understand) but there are certain days (usually following something off protocol) where i have this overwhelming hot flush (all over for me). Anyway, just a thought (and might also explain the slower than expected weight loss). Otherwise, my other guess was deifnitely the hormonal shifts . . .

  3. elsilrac

    carbs from what, veggies?

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My Site - Chapter 15: Hyperglycemic Emergencies In Adults

Diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic state (HHS) should be suspected in ill patients with diabetes. If either DKA or HHS is diagnosed, precipitating factors must be sought and treated. DKA and HHS are medical emergencies that require treatment and monitoring for multiple metabolic abnormalities and vigilance for complications. A normal blood glucose does not rule out DKA in pregnancy. Ketoacidosis requires insulin administration (0.1 U/kg/h) for resolution; bicarbonate therapy should be considered only for extreme acidosis (pH7.0). Note to readers: Although the diagnosis and treatment of diabetic ketoacidosis (DKA) in adults and in children share general principles, there are significant differences in their application, largely related to the increased risk of life-threatening cerebral edema with DKA in children and adolescents. The specific issues related to treatment of DKA in children and adolescents are addressed in the Type 1 Diabetes in Children and Adolescents chapter, p. S153. Diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic state (HHS) are diabetes emergencies with overlapping features. With insulin deficiency, hyperglycemia causes urinary Continue reading >>

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  1. Firehawk734

    Does anybody have any experience with Ketogenic Diets and Anxiety levels?
    I've heard that these diets that are ultra low carb most of the time, can increase anxiety levels in people. I started one for about 4 weeks just today, but want to be prepared lol. I assume to expect the worst, like everything else.

  2. mvw

    Firehawk I do not have any experience in diets and anxiety, but I think a diet can create sensations similar to those of anxiety cause of a lack of carbohydrates. In a diet you are taking less then your daily required nutrients. Lightheadedness, feeling faint/weak, shakey ect. So i does not increase your anxiety (I think thats impossible) but it does create sensations which are similar to anxiety. Additionally, it might result in you not being able to cope as well with anxiety, cause you are feeling weaker due to lack of nutrients?? Why are you starting this diet exactly? To lose weight? I am not experienced in diets or anything, but could be nice to discuss it in more detail, as I am also trying to improve my eating habits while doing lots of sports.

  3. Firehawk734

    Nutrition and Exercise is one of my favorite things to discuss and I'd love to tell you any experiences that I have had if it helps you.
    The short story for me is that i was the chubby kid all my life and at almost 35 now, I have lost 141lbs over the past few years, starting at 342lbs (the biggest I knew i was at the doctor, could have been more at some point) and am currently at 201lbs. I've taken my body fat percentage from 50% down to 15% and have sort of hit a wall. I've done multiple diets over this period of time but generally I change things up every now and then.
    Ketogenic diets are used by bodybuilders to get themselves very lean. It's not a diet for anybody because it requires great self control and discipline and it's hard enough to stick with any diet plan let alone one that doesn't allow carbs. But becuase of the nature of it, where carbs are dropped low, and the only carbs permitted are green veggies basically most of the time, it makes the diet very tough. I only want to run it for about 6 weeks and that's primarily why. There are studies out there that suggest Keto diets are used in the medical world, and are being studied more and more, for people with certain kinds of medical conditions, but I don't know all the history on that part of it. Google it and stuff comes up for this.
    I am going to run this diet for probably about 6 weeks or so to see if i can get through my plateau. I hit 201lbs a couple months ago and have been stuck here even after adjusting calorie levels.
    I weightlift 4-5 days a week and do cardio 1-2 days a week. I usually don't take a day off, as I don't feel I need it, but will take one when I feel the need. I just like to make sure I stay active. Being at this for several years now I am pretty in tune with my body so I try to listen to it.
    I enjoy sports as well. I did 3 powerlifting competitions a few years ago, but my goals don't really correlate with that of powerlifting. It's hard to get as strong as possible while cutting because they are contradictory.
    What I'm trying to do is lean out to about 10% body fat, and then start worrying about building muscle mass and strength. I'm almost there, maybe 10-12 more lbs to go, but I have been struggling to get through my plateau like I said, so the Keto diet is a bit of an extreme diet relative to other diets and I figured why not.
    But I had read that keto diets can worsen anxiety levels. And I'm going to go through it one way or the other, but wanted to see if anybody had any info on this. Doing some research yesterday I found that some guys that have panic disorder claim it actually levels them out a bit after the initial week or two where your body adjusts. I could see lightheadedness and other sensations being generated while your body adapts. That makes sense.
    I figure at 190ish I'll be shredded. Maybe 185. We'll see what happens, but I am so looking forward to it. I'm in the best shape of my life and the most active I've ever been. I don't think I've been under 200lbs since birth lol. I was probably in 7th or 8th grade the last time I was under 200lbs, honestly. Like I said, I was the chubby kid from age 7 on. I played ice hockey when I was 7 yrs old, and was in pretty good shape back then but after I got out of hockey I started gaining weight. This was a self esteem issue. I ended up becoming a binger (eating disorder). I still deal with that eating disorder, but I'm able to keep it limited to holidays and other special situations now. A binge day for me is around 12-15,000 calories.
    And like I told the therapist, if I could tolerate puking, I'd stick my finger down my throat, because it takes a good 1-2 weeks to recover from one of my cheat days lol.
    Yesterday I had a few episodes of lightheadedness but they didn't amount to much else than that.

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    The hallmark of diabetes is a raised plasma glucose resulting from an absolute or relative lack of insulin action. Untreated, this can lead to two distinct yet overlapping life-threatening emergencies. Near-complete lack of insulin will result in diabetic ketoacidosis, which is therefore more characteristic of type 1 diabetes, whereas partial insulin deficiency will suppress hepatic ketogenesis but not hepatic glucose output, resulting in hypergl ...

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    HHS is a condition of: Extremely high blood sugar (glucose) level Decreased alertness or consciousness (in many cases) Buildup of ketones in the body (ketoacidosis) may also occur. But it is unusual and is often mild compared with diabetic ketoacidosis. HHS is more often seen in people with type 2 diabetes who don't have their diabetes under control. It may also occur in those who have not been diagnosed with diabetes. The condition may be brough ...

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    Go to: Diabetic Ketoacidosis Prior to the discovery and isolation of insulin in 1922 by Banting and Best, type 1 diabetes was universally fatal within a few months of initial diagnosis. Once mass production was started, the challenge to those early pioneers of insulin treatment was learning how to use this new wonder drug, e.g., how much to give and how often to give it, in order to treat the hyperglycemia without raising the inherent risk of hyp ...

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    DKA vs HHS “DKA” means “diabetic ketoacidosis” and “HHS” means “Hyperosmolar Hyperglycemic Syndrome.” Both DKA and HHS are the two complications of diabetes mellitus. Though there are many differences between DKA and HHS, the basic problem is associated with insulin deficiency. When comparing the two, HHS has a higher mortality rate. When DKA has a mortality rate of 2 to 5 per cent, HHS has a 15 per cent mortality rate. Diabetic k ...

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    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 hyperglyc ...

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