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Ketoacidosis Is Usually A Result Of _______

Diabetic Ketoacidosis

Diabetic Ketoacidosis

Diabetic ketoacidosis (DKA) is a serious, life-threatening complication of diabetes mellitus. DKA is characterized by the triad of hyperglycemia, anion gap metabolic acidosis, and ketonemia. It is part of a spectrum of hyperglycemia on which lies hyperosmolar hyperglycemic state (HHS). Though the two are distinct entities, they do share some commonalities. DKA is caused by the reduced effect of insulin, either due to deficit or reduction of levels, with concomitant elevation of counter regulatory hormones (glucagon, catecholamines, cortisol, and growth hormones), generally due to a precipitating stress. Increased gluconeogenesis, glycogenolysis, and decreased glucose uptake by cells leads to hyperglycemia, while insulin deficiency leads to mobilization and oxidization of fatty acids leading to ketogenesis. Although DKA may be the initial manifestation of diabetes, it is typically precipitated by other factors. It is critical for a clinician to identify and treat these factors. Infection can be found in 40-50% of patients with hyperglycemic crisis, with urinary tract infection and pneumonia accounting for the majority of cases. DKA is a life-threatening medical emergency with a mortality rate just under 5% in individuals under 40 years of age, but with a more serious prognosis in the elderly, who have mortality rates over 20%. Deaths may also occur as a result of hypokalemia induced arrhythmias and cerebral edema (more common in children). Although the diagnosis of DKA can be suspected on clinical grounds, confirmation is based on laboratory tests including potential hydrogen (pH) level, urinalysis, and basic metabolic profile. Table I. Adapted from American Diabetes Association diagnostic criteria for diabetic ketoacidosis Mild Moderate Severe Plasma glucose >250 >250 > Continue reading >>

Diabetic Ketoacidosis

Diabetic Ketoacidosis

Diabetic ketoacidosis (DKA) is a potentially life-threatening complication of diabetes mellitus.[1] Signs and symptoms may include vomiting, abdominal pain, deep gasping breathing, increased urination, weakness, confusion, and occasionally loss of consciousness.[1] A person's breath may develop a specific smell.[1] Onset of symptoms is usually rapid.[1] In some cases people may not realize they previously had diabetes.[1] DKA happens most often in those with type 1 diabetes, but can also occur in those with other types of diabetes under certain circumstances.[1] Triggers may include infection, not taking insulin correctly, stroke, and certain medications such as steroids.[1] DKA results from a shortage of insulin; in response the body switches to burning fatty acids which produces acidic ketone bodies.[3] DKA is typically diagnosed when testing finds high blood sugar, low blood pH, and ketoacids in either the blood or urine.[1] The primary treatment of DKA is with intravenous fluids and insulin.[1] Depending on the severity, insulin may be given intravenously or by injection under the skin.[3] Usually potassium is also needed to prevent the development of low blood potassium.[1] Throughout treatment blood sugar and potassium levels should be regularly checked.[1] Antibiotics may be required in those with an underlying infection.[6] In those with severely low blood pH, sodium bicarbonate may be given; however, its use is of unclear benefit and typically not recommended.[1][6] Rates of DKA vary around the world.[5] In the United Kingdom, about 4% of people with type 1 diabetes develop DKA each year, while in Malaysia the condition affects about 25% a year.[1][5] DKA was first described in 1886 and, until the introduction of insulin therapy in the 1920s, it was almost univ Continue reading >>

Exam 4: Lab #10

Exam 4: Lab #10

Sort B Compensation of metabolic alkalosis includes which of the following? A) conserving bicarbonate ion in the renal system B) excreting bicarbonate ion in the renal system and retaining carbon dioxide through the respiratory system C) conserving bicarbonate ion in the renal system and retaining carbon dioxide through the respiratory system D) retaining carbon dioxide through the respiratory system E) excreting bicarbonate ion in the renal system Continue reading >>

Ketoacidosis Is Usually A Result Of

Ketoacidosis Is Usually A Result Of

DKA occurs as a consequence of absolute or relative insulin deficiency - K+ is loss due to shift of K+ from the intracellular to extracellular with exchange of hydrogen ions - acidosis -increase in catecholamines, cortisol, glucagon, and GH - leads to increase glucose production and decrease glucose use of tissue - insulin deficiency leads to reduced glucose uptake, increased fat mobilization with release of fatty acids, accelerated gluconeogenesis and ketogenesis. - increased ketone concentrations - ketones are used to regenerate bicarb - hyperketones may be a result of impairment in the use of ketones, which permits strong organic acid to circulate freely - bicarb buffering does not occur leading to metabolic acidosis Diabetic ketoacidosis (DKA) results from dehydration during a state of relative insulin deficiency, associated with high blood levels of sugar level and organic acids called ketones. Diabetic ketoacidosis is associated with significant disturbances of the body's chemistry, which resolve with proper therapy. Diabetic ketoacidosis usually occurs in people with type 1 (juvenile) diabetes mellitus (T1DM), but diabetic ketoacidosis can develop in any person with diabetes. Since type 1 diabetes typically starts before age 25 years, diabetic ketoacidosis is most common in this age group, but it may occur at any age. Males and females are equally affected. Continue reading >>

Endocrine Disorder Key Terms

Endocrine Disorder Key Terms

Chvostek's sign p.513 an abnormal spasm of the facial muscles elicited by light taps on the facial nerve in patients who are hypocalcemic endocrinologist p.506 glycosuria p.528 hypoglycemia p.535 a less than normal amount of glucose in the blood, usually caused by administration of too much insulin hypokalemia p.521 a condition in which an inadequate amount of potassium, the major intracellular cation, is found in the circulating bloodstream idopathic hyperplasia p.503 ketoacidosis p.528 ketone bodies p.528 what the liver changes fatty acids into when glucose is not available as fuel or cannot be used lipohypertrophy p.534 a subcutaneous skin disorder in which a firm lump under the skin develops after long term subcutaneous insulin injections neuropathy p.537 type 1 diabetes mellitus p.527 progressive destruction of beta cell function in the pancreas as a result of autoimmune process in a susceptible individual adrenocorticohyperplasia excessive development of the adrenal cortex adrenopathy disease of the adrenal gland cortical pertaining to the cortex corticoid resembling the cortex endocrinologist physician who studies and treats diseases of the endocrine (system) endocrinology study of the endocrine corticoid resembling the cortex euglycemia normal (level of) sugar in the blood (within normal range) syndrome run together (signs and symptoms) occurring together that are characteristic of a specific disorder) isthmus narrow strip of tissue connecting two larger parts in the body and nervous development and a metabolic rate as much as 40 percent below normal levels Cushing disease A condition caused by the hyper secretion of glucocorticoids; characterized by the excessive breakdown of lipid reserves and proteins, and relocation of lipids Diabetes insipidus A disorder Ac Continue reading >>

Shared Flashcard Set

Shared Flashcard Set

Details Title patho test 4 Description patho test 4 Total Cards 296 Subject Biology Level Undergraduate 2 Created 03/31/2014 Click here to study/print these flashcards. Create your own flash cards! Sign up here. Additional Biology Flashcards Cards Term What happens in the lungs when the diaphragm relaxes? a. Air is forced out of the lungs. b. Lung volume increases. c. Intrapulmonic pressure decreases. d. Intrapleural pressure decreases. Definition a Term The respiratory mucosa is continuous through the: 1. upper and lower respiratory tracts 2. nasal cavities and the sinuses 3. nasopharynx and oropharynx 4. middle ear cavity and auditory tube a. 1 only b. 1, 2 c. 2, 3 d. 1, 3, 4 e. 1, 2, 3, 4 Definition e Term Which of the following activities does NOT require muscle contractions and energy? a. quiet inspiration b. forced inspiration c. quiet expiration d. forced expiration Definition c Term The maximum volume of air a person can exhale after a maximum inspiration is termed the: a. expiratory reserve volume b. inspiratory reserve volume c. total lung capacity d. vital capacity Definition d Term Which of the following applies to the blood in the pulmonary artery? a. PCO2 is low. b. PO2 is low. c. Hydrostatic pressure is very high. d. It is flowing into the left atrium. Definition b Term Which of the following causes bronchodilation? a. epinephrine b. histamine c. parasympathetic nervous system d. drugs that block beta-2 adrenergic receptors Definition a Term The central chemoreceptors are normally most sensitive to: a. low oxygen level b. low concentration of hydrogen ions c. elevated oxygen level d. elevated carbon dioxide level Definition d Term 97. Which of the following individuals is NOT considered to be at high risk for developing active tuberculosis? a. homeless in Continue reading >>

Endorcine

Endorcine

ENDOCRINE PHYS and PHARM Endocrine disorders – part 1 David Simcock Endocrinology = hormones Structure • Part 1 – Introduction and focus questions • Part 2 (lecture time) – Workshop on disorders in hormones controlling water retention, metabolism, growth and stress • Part 3 (lecture time) – Workshop on disorders in glucose metabolism • Part 4 (tutorial time) – Evolving case studies in endocrine disorders Today’s objectives • Its all about normal function i.e. what hormone should do • Revise how hormones act e.g. peptides vs steroids • Revise the following hormones and what they do – – – – – – – ADH water retention Aldosterone sodium and potassium balance Growth hormone growth, esp in children Thyroid hormone metabolic rate in cells (parathyroid hormone) calcium regulation Cortisol modulation of stress responses Insulin regulation of blood glucose • Introduce material to be studied before workshops Marieb is back! • Mastering A and P on LearnJCU • Assignments for self testing The most important points to consider for this module • What does the hormone do? What does it regulate, on which Organs does it act? • What if there is too much of it? Over-effective action, what will this Do to the body? • What if there is too little of it? ineffective action, what will this do to the body? • How could we treat an imbalance? Replace it? Inhibit its release? Block its receptor? Remove secreting tissue? Treat symptoms? Classes and their modes of action • Hormones act on receptors • Where is the receptor? – Peptides, amines – on the plasma membrane – Steroids, thyroid hormones* – in the cell * Thyroid hormones are peptides with steroid like properties Hormonal clearance • Is it water soluble? – Yes = kidneys can cl Continue reading >>

Anps 20 Lab #10

Anps 20 Lab #10

Sort e Compensation of metabolic alkalosis includes which of the following? a. retaining carbon dioxide through the respiratory system b. conserving bicarbonate ion in the renal system c. excreting bicarbonate ion in the renal system d. conserving bicarbonate ion in the renal system and retaining carbon dioxide through the respiratory system e. excreting bicarbonate ion in the renal system and retaining carbon dioxide through the respiratory system Continue reading >>

Bio 318 Lab 2

Bio 318 Lab 2

Size: 94 Carbon dioxide (CO2) from tissue cells forms ________ when combined with water. This compound dissociates into H+ and ________, and participates in an important buffering system in the blood. Continue reading >>

Rfowler82

Rfowler82

How to study your flashcards. Right/Left arrow keys: Navigate between flashcards. Up/Down arrow keys: Flip the card between the front and back. H key: Show hint (3rd side). A key: Read text to speech. Share Print Export Clone 459 Cards in this Set Front Back ADH is formed in the ------------ Hypothalamic supraoptic nuclei ADH is stored in the ------------- Posterior Pituitary ADH release is stimulated by: Increased Serum Osmolarity, Anesthesia/Analgesics, Stress/Pain S/S of SIADH: 1. 2. 3. Increased Urine Osmolarity Decreased Serum Sodium Decreased Serum Osmolarity ADH works on the -------- Distal convoluted and collecting tubule of the kidney to reabsorb water, thus concentrating urine. Normal Serum Osmolarity ------ 275-295 mOS/L Osmol = 2(NA) + BUN/5 + GLU/20 Treatment for SIADH: 1.) --------- 2.) -------- 3.) -------- 1.) Fluid Restriction 2.) 3% NaCl (increase Na) 3.) Lithium/Phenytoin (inhibits ADH) Causes of SIADH: Cancer and Chemotherapy (Oat Cell Carcinoma, Prostatic, Pancreatic) Viral PNA Brain problems Observe for ST depression/angina or abdominal cramps (mesenteric ischemia) with the administration of: ADH = Vasopressin = Pitressin DI results from: 1.) ------------- 2.) ------------ 3.) ------------ 1.) Head Trauma 2.) Dilantin 3.) Hypophysectomy Diabetes Insipidus is caused by ------------ - decreased levels of ADH Complications of DI include: 1.) ---------- 2.) ---------- 1.) Dehyrdation / Hypernatremia 2.) Hypovolemic Shock S/S of DI: 1.) --------- 2.) --------- 3.) --------- 4.) --------- 1.) Decreased SpGr 1.000-1.005 2.) Increased Serum Osmolarity 3.) Increased Serum Sodium 4.) Increased UOP An ABG of a DKA patient shows CO2 levels are ------- due to -------- ---------- stimulated by the state of acidosis. 1.) Decreased 2.) Kussmaul Respirations Acidos Continue reading >>

Idr Block 5

Idr Block 5

Term Definition Candida [C. albicans] _____species are oval, narrow budding yeasts. _____can make pseudohyphae/“germ tubes”. common in oropharyngeal, gastrointestinal, and female genital flora. Pseudohyphae produce proteinases invasion into the extracellular matrix. has receptors that bind C3 proteinases C. albicans species are oval, narrow budding yeasts. can make pseudohyphae/“germ tubes”. common inoropharyngeal, gastrointestinal, and female genital flora. Pseudohyphae produce _______ invasion into the extracellular matrix. has receptors that bind C3 germ tubes C. albicans species are oval, narrow budding yeasts .can make pseudohyphae/____ ___. common in oropharyngeal, gastrointestinal, and female genital flora. Pseudohyphae produce proteinases invasion into the extracellular matrix. has receptors that bind C3 Candida [C. albicans] Causes white Oral thrush in the immunocompromised. Bleeds upon attempted removal. C. albicans _______infects the mucosa up to the cervix. produces a thick, curd-like discharge and itching of the vulva. “Cheese/bread smelling” exudate. grows better with glucose. diaper rash C. albicans #1 cause of _____ ______ in babies. The initial lesions are erythematous papules or confluent areas associated with tenderness, erythema, and skin fissures (dry cracking skin.) Fungemia, septicemia Candida is the #1 cause of _____, and the #3 cause of _____ overall fluconazole Even though candida is the fungus with the highest rate of resistance, we can still assume that it is still susceptible to most of our treatments. Treat C. albicans with _______ Fluconazole [triazoles] C. glabrata and C. krusei, are resistant to _______, so if those species have not been ruled out, echinocandins/amphotericin B should be used. melanin Cryptococcus neoformans a Continue reading >>

Ch67_diabetes

Ch67_diabetes

Hyperglycemia results from problems w/ insulin _____ &/or insulin ____. Flashcards Matching Hangman Crossword Type In Quiz Test StudyStack Study Table Bug Match Hungry Bug Unscramble Chopped Targets Iggy Ch67 Diabetes Question Answer Hyperglycemia results from problems w/ insulin _____ &/or insulin ____. Insulin secretion &/or insulin action Tx of _______ & ______ is essential to prevent DM complications. Hypertension & Hyperlipidemia DM Type 1 classification ______ destruction leading to absolute insulin deficiency. Beta-cell DM Type 2 classification ranges from insulin ______ w/ relative insulin _____ to ____ _____ w/ insulin resistance. Insulin resistance w/ relative Insulin deficiency to Secretory deficit w/ Insulin resistance In the pancreas, the Two types of Islets of Langerhans cells are important to glucose control: ____ & ____. Alpha & Beta Cells Dm is the leading cause of _____, _____, & ______. Blindness, End-stage Renal disease & Amputations Alpha Cells produce ____. Glucagon (A Counterregulatory hormone opposing insulin) Glucagon releases ____ from the cell storage sites when ____ ____ levels are low. Glucose, Blood glucose Beta cells produce ____ &___. Insulin & Amylin Insulin allows the body cells to use & store _____, _____, & ____. Cards, Fats & Proteins Initially, an insulin precursor is produced by the Pancreas called _____. Proinsulin Proinsulin is received by the Liver and transformed into _____ _____. Active Insulin Active insulin then attaches to insulin sites to promote _____ transport thru cell membranes. Glucose In muscle, insulin promotes ___ & ____ synthesis. Protein & Glycogen In fat, insulin keeps blood glucose from becoming too ____ & blood _____ in normal range. high, Lipids Glucose & Free fatty acids are stored in cells as ____ in the Li Continue reading >>

These Are Designed To Be Printed In Landscape Mode On 4x6 Index Cards.

These Are Designed To Be Printed In Landscape Mode On 4x6 Index Cards.

Click here to tell your browser to print these cards. These are designed to be printed in landscape mode on 4x6 index cards. To save paper, we recommend using your computer's print preview until you get your printer settings correct. Body Water Content Total water content declines throughout life Body Water Content Healthy males are about 60% water; healthy females are around 50% This difference reflects females’: Higher body fat and Smaller amount of skeletal muscle Intracellular fluid (ICF) Extracellular fluid (ECF) Water occupies two main fluid compartments Intracellular fluid (ICF) about two thirds by volume, contained in cells Extracellular fluid (ECF) consists of two major subdivisions Plasma – the fluid portion of the blood Interstitial fluid (IF) – fluid in spaces between cells Other ECF – PERI AND ENDO lymph, cerebrospinal fluid, AQUEOUS VISCOUS eye humors, synovial fluid, serous fluid, and gastrointestinal secretions Extracellular fluid (ECF) Interstitial fluid, plasma, and other body fluids Intracellular fluid (ICF) The cytosol Fluid balance The amount of water gained each day equals the amount lost Electrolyte balance The ion gain each day equals the ion loss Acid-base balance H+ gain is offset by their loss Electrolytes inorganic salts, all acids and bases, and some proteins Nonelectrolytes examples include glucose, lipids, creatinine, and urea Which has greater osmotic power electrolytes or nonelectrolytes? Electrolytes have GREATER osmotic power than nonelectrolytes What does water move according to? Water moves according to OSMOTIC GRADIENTS! ECF Major components and Minor components MAJOR components include the interstitial fluid and plasma MINOR components include all other ECF Antidiuretic hormone (ADH) Stimulates water conservation and the th Continue reading >>

Pathophysiology

Pathophysiology

Pathophysiology Final exam review FILL IN THE BLANKS 1.The study of diseases that can cause abnormalities in the structure of function of the organ systems in the body is _____________. 2.The measurable characteristics that the patient exhibits as a result of the disease process are referred to as _____________. 3.The characteristics that the patient feels and describes as a result of a disease are ______. 4.Alterations of cell growth are known as ________. 5.Adverse patient conditions caused by treatment by a physician are known as ________. 6.If the underlying cause of a disease is unknown, it is termed ____________. 7.Infections contracted within the healthcare facility are _______ infections. 8.Contagious diseases contracted outside the healthcare facility are _______ infections. 9.The immediate response of the body to local injury is ____________. 10.As a result of inflammation, there are four overlapping responses which are: a. __________ b. __________ c. __________ d. __________ 11.The term ________ describes the ability of fluids to pass from one structure to another. 12.Inflammatory ______ causes the swelling associated with inflammation and is caused by protein-rich fluid resulting in pressure and pain. 13.Fibrous scar tissue replaces destroyed tissue with _______ tissue. 14.Fibrous scars are a result of strong connective tissue contracting to form a/an _________ in the abdomen. 15.A protruding tumor-like scar known as _______ results from an accumulation of excessive amounts of collagen. 16.List the 5 clinical signs of acute inflammation. 1. _______ 2. ________ 3. ________ 4. ________ 5. ________ 17.Microcirculation at the injury site results in ______ and ______. 18.Swelling because of the exudate is also known as ___________. 19.As a result of the swelling, Continue reading >>

Type 1 Dm

Type 1 Dm

Type 1 DM Question Answer Sudden onset type 1 dm is associated with what symptoms? polyuria/polydipsia, weight loss despite polyphagia, lethargy What cell types are outside of the alpha cells and what do they secrete? delta cells (somatostatin) and PP cells (pancreatic polypeptide) HLA associations ____ and_____ are located on what chromosome? HLA DR3/4 and DQB1 on chromosome 6p What infectious etiologies could cause Type 1 DM? rubella congenital, coxscakie B4 virus, echovirus, mmps, CMV Coxsackie can cause type 1 DM why? have GAD protein similarity What are the general environmental triggers that can cause Type 1 DM? infection, dietary, and psychsocial What antibodies are suggestive of type 1 dm? GAD (gluatamic acid decarboxylase), ICA512 (islet cell antibodies), insulin autoantibodies (IAA), insulinoma associated protein-2 (IA-2) What climates are associated with Type 1 DM? cold climate What signs and symptoms of DKA are seen as a result of ketogenesis? N/v, abdominal pain, depressed sensorium, hyperventilation with kussmail respiration, fruity breath, shock What three labs are needed for DKA diagnosis? hyperglycemia > 250, acidosis < 7.3 (bicarb < 18 and anion gap > 10), and ketosis What are the electrolyte disturbances typically seen in DKA? bicarb is low, hypernatremia (if dehydrated), hyperkalemia....(hyperkalemia will drop to hypokalemia with insulin) Protamine and zinc linked isulin must be administered in what way? subq What are the new insulin analogues with short onset of action? lispro/aspart/glulisine memorize Type 2 DM Question Answer 42% of diabetes costs are related to what? hospitalization and long term care Thin diabetic has what typical twin concordance? 40-50% (TYPE 1) What are the typical defects (5 of em) seen in type 2 dm? reduced insulin secretio Continue reading >>

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