diabetestalk.net

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 >>

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 >>

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 >>

Notes 13

Notes 13

Chapter 13 Endocrine System Notes The endocrine system comprises a network of_________________ glands that produce specific effects on body functions. Hormones- chemical substances that act like _________________molecules in the body. Exocrine gland-Glands that release their secretions through a _________________ Target organs/ Target tissues- the _________________or _________________that are _________________ to the effects of hormones Hyposecretion- A hormone that is _________________ produced Hypersecretion- A hormone that is_________________produced Pituitary gland/ Hypophysis- the “_________________ gland” it regulates many body activities and _________________ other glands to *About the size of a _________________ and found at the base of the _________________. A)Anterior lobe-adnohypophysis-Produces 6 hormones that are released *It also secretes 2 hormones into the B)Posterior lobe-Neurohypophysis-Stores the 2 hormones and Thyroid gland Thyroid gland- _________________gland in the _________________system located just below the larynx. Isthmus- strip of tissue that connects the _________________- (T4)-Major hormone secreted by the thyroid Triiodothyronine- (T3)-Usually _________________from T4 at the_________________tissue. Thyroid Hormone(TH)-Virtually affects every cell in the body.(not adult brain, spleen, testes, uterus, and thyroid gland itself. *TH also influences Parathyroid glands Parathyroid glands- consists of at least _______________separate _____________ located on the _________________ surface of the lobes of the thyroid gland Parathyroid Hormone(PTH)-Only hormone secreted from the prarthyroid. *PTH helps regulate _________________balance by stimulating three target organs: bones, kidneys and intestines. *PTH causes phosphates and calcium to be __

Unit 6 Preparations

Unit 6 Preparations

FN 255: Introduction to MNT Teresa McFerran, MS, RD Health Professions Division Lane Community College Eugene, Oregon , Chapter 17 Diabetes Mellitus You do NOT need to print this document, if you have printed the Unit 6 Outline. ACTIVITIES AT A GLANCE. Check them off as you complete them. By midnight (11:55 pm) SUNDAY, complete Unit 6 Study Questions for 10 points (be certain you've FIRST done ALL of the Unit Preparation Questions). (If you have any questions, post them in our "Forum Week 6" in Moodle.) Sometime BEFORE SUNDAY, participate in our "Forum Week 6" by making at least two postings throughout the week with at least one of the postings BEFORE Friday evening. So the total MINIMUM is 2 postings on TWO different days. (A posting can be either posting a question you have or replying to a classmate's question or comment. You don't have to respond to all of the threads if you don't feel you have anything to add. You can also choose to respond more often.) OBJECTIVES After reading the assigned reading, filling out the Unit Preparations below, participating in the "Forum Week 6", and completing the Unit 6 Study Questions, you will be able to: Define the different types of diabetes and how they are diagnosed. Describe the most common complications associated with diabetes and how the risk of these complications can be reduced through glycemic control. Name the ABCs of Diabetes Control, and describe the role that nutrition, physical activity, and medications play in managing diabetes. Understand the different therapeutic dietary modifications that may be ordered with diabetes and when they may be appropriate. Continue understanding common medical nutrition terminology and relevant laboratory values. RESOURCES Unit 6 Preparations (this document) Mosby's Pocket Guide Serie 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 >>

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 >>

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 >>

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 >>

Newborn Screening: New Opportunities And New Challenges

Newborn Screening: New Opportunities And New Challenges

Abstract Newborn screening is an old technique for early detection of problems and health promotion. In recent times, genetic breakthroughs have created the possibility of testing for many more newborn conditions. Some states are mandating as many as 20 to 30 tests. This article will review newborn screening, the state of the art, and some of the ethical questions that our technology is raising. Copyright 2002, Elsevier Science (USA). All rights reserved. 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 >>

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 >>

Diabetes & Hypoglycemia

Diabetes & Hypoglycemia

8.0 Contact Hours California Board of Registered Nursing CEP#15122 Terry Rudd RN, MSN, CCRN Key Medical Resources, Inc. 6896 Song Sparrow Rd, Corona, Ca 92880 951 520-3116 FAX: 951 739-0378 DIABETES AND HYPOGLYCEMIA HOME STUDY 8.0 C0NTACT HOURS 8.0 C0NTACT HOURS CEP #15122 70% is Passing Score Please note that C.N.A.s cannot receive continuing education hours for home study. Key Medical Resources, Inc. 6896 Song Sparrow Rd., Corona, CA 92880 1. Please print or type all information. 2. Complete answers and return answer sheet with evaluation form via fax or email to Key Medical Resources, Inc. Email: [email protected] FAX: 951 739-0378 Name: ________________________________ Date Completed: ______________ Score____ Email:_____________________________ Cell Phone: ( ) ______________ Certificate will be emailed to you. Address: _________________________________ City: _________________ Zip: _______ License # & Type: (i.e. RN 555555) _________________Place of Employment: ____________ Please place your answers on this form. . 1. _____ 2. _____ 3. _____ 4. _____ 5. _____ 6. _____ 7. _____ 8. _____ 9. _____ 10. _____ 11. _____ 12. _____ 13. _____ 14. _____ 15. _____ 16. _____ 17. _____ 18. _____ 19. _____ 20. _____ 21. _____ 22. _____ 23. _____ 24. _____ 25. _____ 26. _____ 27. _____ 28. _____ 29. _____ 30. _____ 31. _____ 32. _____ 33. _____ 34. _____ 35. _____ 36. _____ 37. _____ 38. _____ 39. _____ 40. _____ My Signature indicates that I have completed this module on my own._________________________________ (Signature) Poor Excellent 1. The content of this program was: 1 2 3 4 5 6 7 8 9 10 2. The program was easy to understand: 1 2 3 4 5 6 7 8 9 10 3. The objectives were clear: 1 2 3 4 5 6 7 8 9 10 4. This program applies to my work: 1 2 3 4 5 6 7 8 9 10 5. I learned somethin 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 >>

Ketoacidosis

Ketoacidosis

Ketoacidosis is a metabolic state associated with high concentrations of ketone bodies, formed by the breakdown of fatty acids and the deamination of amino acids. The two common ketones produced in humans are acetoacetic acid and β-hydroxybutyrate. Ketoacidosis is a pathological metabolic state marked by extreme and uncontrolled ketosis. In ketoacidosis, the body fails to adequately regulate ketone production causing such a severe accumulation of keto acids that the pH of the blood is substantially decreased. In extreme cases ketoacidosis can be fatal.[1] Ketoacidosis is most common in untreated type 1 diabetes mellitus, when the liver breaks down fat and proteins in response to a perceived need for respiratory substrate. Prolonged alcoholism may lead to alcoholic ketoacidosis. Ketoacidosis can be smelled on a person's breath. This is due to acetone, a direct by-product of the spontaneous decomposition of acetoacetic acid. It is often described as smelling like fruit or nail polish remover.[2] Ketosis may also give off an odor, but the odor is usually more subtle due to lower concentrations of acetone. Treatment consists most simply of correcting blood sugar and insulin levels, which will halt ketone production. If the severity of the case warrants more aggressive measures, intravenous sodium bicarbonate infusion can be given to raise blood pH back to an acceptable range. However, serious caution must be exercised with IV sodium bicarbonate to avoid the risk of equally life-threatening hypernatremia. Cause[edit] Three common causes of ketoacidosis are alcohol, starvation, and diabetes, resulting in alcoholic ketoacidosis, starvation ketoacidosis, and diabetic ketoacidosis respectively.[3] In diabetic ketoacidosis, a high concentration of ketone bodies is usually accomp Continue reading >>

More in ketosis