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Ketoacidosis Word Parts

When Dka And I Met For The Firsttime

When Dka And I Met For The Firsttime

I saw a post last night that a friend shared about a young girl with Type 1 diabetes that had passed away. Her pump site apparently kinked and she went into DKA and then had brain damage, so her parents had to make the heartwrenching decision to remove her from life support. This led to a conversation with a couple of friends as I recounted my story of my first time in DKA. It will be forever ingrained in my head, so I thought Id share it here as well. I was in college 3+ hours away from home. And about 4 1/2 years post dx. I was visiting my boyfriends house and started feeling really sick. Started vomiting. To the point of not being able to get up off of the bathroom floor. I called the campus nurse and she told me to drink some Diet Sprite. Couldnt hold it down. Water? Couldnt hold it down. Anything I put in, came right back up. This is not a good combination for anyone, but especially for a diabetic. At the time I had NO idea how serious this was, but I was about to find out. After several hours of this cycle my boyfriend needed to go to work but didnt want to leave me alone. My mom was coincidentally going to be visiting me that weekend so he called the hotel to leave a message for her, not expecting her for another hour or so. (this part gives me chills.) When the hotel front desk answered and he asked to leave a message for her, the receptionist said, Oh, she is standing right here checking in. She had gotten on the road earlier than expected. He told her I was very sick and he thought she should come stay with me, because I was too sick to drive back to my dorm. She immediately heads over there (a 20 min drive that maybe took her 10 min) and saw it was bad. I was sooo soo incredibly sick. She said I needed to go to the ER, but I couldnt walk. So they had to pick Continue reading >>

Hcc University: Coding Clinic Clarifies Diabetes And Complications, Ketoacidosis, And Anti-mag Polyneuropathy

Hcc University: Coding Clinic Clarifies Diabetes And Complications, Ketoacidosis, And Anti-mag Polyneuropathy

SCAN is committed to partnering with our physician providers in offering high quality geriatric care to our members. A significant part of that effort is to assist our providers in the provision of accurate coding that will contribute to the quality of care and support the expected revenue from the Medicare program. To this end, we present the following tools and education for all the physicians and groups providing care to our members. Coding Clinic Clarifies Diabetes and Complications, Ketoacidosis, and Anti-MAG Polyneuropathy Apparently the Q1 2016 "clarification" of diabetes with associated conditions confused many people. In Q2, 2016, Coding Clinic furthers their clarification by stating: "The subterm "with" in the Index should be interpreted as a link between diabetes and any of those conditions indented under the word "with." The physician documentation does not need to provide a link ..... These conditions should be coded as related even in the absence of provider documentation explicitly linking them, unless the documentation clearly states the conditions are unrelated.... For conditions not specifically linked by these relational terms in the classification, provider documentation must link the conditions in order to code them as related." Coders will have to look to the Index and/or the code description for the term "with" in order to make the determination whether or not the physician must specifically link the diabetes to the complication. Coding Clinic also addressed Ketoacidosis in Diabetes. They noted that physicians should be queried if they do not specify the type (i.e. Type 1 or Type 2) of diabetes. In most cases, when a physician does not state the type of diabetes, the default is Type 2, due to coding rules. However, ketoacidosis occurs most freque Continue reading >>

Blood Ketones

Blood Ketones

On This Site Tests: Urine Ketones (see Urinalysis - The Chemical Exam); Blood Gases; Glucose Tests Elsewhere On The Web Ask a Laboratory Scientist Your questions will be answered by a laboratory scientist as part of a voluntary service provided by one of our partners, the American Society for Clinical Laboratory Science (ASCLS). Click on the Contact a Scientist button below to be re-directed to the ASCLS site to complete a request form. If your question relates to this web site and not to a specific lab test, please submit it via our Contact Us page instead. Thank you. Continue reading >>

Alcoholic Ketoacidosis & Lacticacidosis

Alcoholic Ketoacidosis & Lacticacidosis

A 39 year-old female with a history of severe alcohol abuse presents to the ED with altered mental status. Her initial blood sugar is 57. A family member arrives to share that she has recently had epigastric pain and several episodes of emesis, limiting her alcohol intake. The patient is tachycardic, her blood pH is 7.4, lactate is 20, ketones are present in her serum, and she has an anion gap of 44. AT RISK: alcoholics who binge followed by several days of vomiting, decreased food intake, dehydration, and abstinence from alcohol CLINICAL EXAM FINDINGS: tachypnea, dehydration, ketonuria, serum glucose <200 mg/dL, typically normal blood pH despite ketonemia due to coexisting respiratory and metabolic alkalosis (vomiting) -the increased ketones are likely due to acute starvation in a patient who is chronically malnourished alcohol is metabolized by alcohol dehydrogenase using NAD+ as a cofactor to form acetaldehyde and NADH -the presence of NADH combines with pyruvate to form lactate and NAD+ -lactate cannot be metabolized in the reverse reaction without thiamine, a cofactor for pyruvate dehydrogenase Normal saline, thiamine (to metabolize the lactate), glucose, correction of electrolyte abnormalities (hypokalemia, hypomagnesemia) Clinical improvement is typically detected within hours of therapy, however these patients should be admitted for complete correction of fluid, electrolyte, and nutritional deficiencies Figure 1. The role of thiamine in aerobic metabolism. If glucose is administered without thiamine, the metabolic demand for thiamine increases, which may precipitate or worsen lactic acidosis. This may also trigger Wernicke-Korsakoff syndrome or wet or dry beriberi. Continue reading >>

Diabetes Glossary

Diabetes Glossary

Antibodies Antibodies are specialized proteins that are part of the immune system. They are created when an antigen (such as a virus or bacteria) is detected in the body. The antibodies bond with the specific antigen that triggered their production, and that action neutralizes the antigen, which is a threat to the body. Antibodies are created to fight off whatever has invaded the body. See also autoantibodies. Antigens An antigen is a foreign substance (such as a virus or bacteria) that invades the body. When the body detects it, it produces specific antibodies to fight off the antigen. Autoantibodies Autoantibodies are a group of antibodies that “go bad” and mistakenly attack and damage the body’s tissues and organs. In the case of type 1 diabetes, autoantibodies attack the insulin producing beta cells in the pancreas. Autoimmune disorder If you have an autoimmune disorder (also called an autoimmune disease), your body’s immune system turns against itself and starts to attack its own tissues. Basal secretion (basal insulin) We all should have a small amount of insulin that’s constantly present in the blood; that is the basal secretion. People with type 1 diabetes must take a form of insulin that replicates the basal secretion throughout the day; that’s basal insulin. Beta cells Beta cells are located in the islets of Langerhans in the pancreas. They are responsible for making insulin. Blood glucose level The blood glucose level is how much glucose is in your blood at a given time. This level is very important for people with diabetes, and they must monitor their blood glucose level throughout the day. If the blood glucose level is too high (hyperglycemia), that means that there isn’t enough insulin in the blood. If it’s too low (hypoglycemia), that mean Continue reading >>

Diabetes Mellitus (type 1, Type 2) & Diabetic Ketoacidosis (dka) - Causes & Symptoms

Diabetes Mellitus (type 1, Type 2) & Diabetic Ketoacidosis (dka) - Causes & Symptoms

Diabetes mellitus (type 1, type 2) & diabetic ketoacidosis (DKA) - causes & symptoms What is diabetes mellitus? Diabetes mellitus is when there's too much glucose, a type of sugar, in the blood. Diabetes mellitus can be split into type 1, type 2, as well as a couple other subtypes, including gestational diabetes and drug-induced diabetes. Subscribe - goo.gl/w5aaaV. More videos - goo.gl/UhOKiM. Support us on Patreon - goo.gl/ZGHEk4. This video covers the pathophysiology behind each type, complications (including diabetic ketoacidosis and hyperosmolar hyperglycemic state), symptoms, and management. Subscribe - ru-clip.com/channel/UCNI0qOojpkhsUtaQ4_2NUhQ This video is brought to you by Osmosis. Along with providing open-access videos, Osmosis offers a comprehensive e-learning platform that connects med students with thousands of flashcards and quiz questions, depending on each student's needs. Ever wish information would just diffuse into your brain? Well, Osmosis helps make that possible-don't learn it, osmose it! We also have free practice questions for the USMLE and NCLEX-RN exams here: goo.gl/3oGOEi This video is licensed under a Creative Commons CC-BY-SA 4.0 international license, which means that you're free to share and adapt it so long as you follow the Attribution and ShareAlike terms and conditions! Diabetic retinopathy illustration by BruceBlaus - en.wikipedia.org/wiki/Diabetic_retinopathy#/media/File:Blausen_0312_DiabeticRetinopathy.png Blood squirt sound effect by Mike Koenig - soundbible.com/828-Blood-Squirt.html Water drop low sound effect by Mike Koenig - soundbible.com/1139-Water-Drop-Low.html Prednisone was applied to heal my pneumonia, nevertheless, the medication also stimulated the rise of my blood sugar levels which ended in diabetic issues. At that Continue reading >>

Diabetic Ketoacidosis

Diabetic Ketoacidosis

Print Overview Diabetic ketoacidosis is a serious complication of diabetes that occurs when your body produces high levels of blood acids called ketones. The condition develops when your body can't produce enough insulin. Insulin normally plays a key role in helping sugar (glucose) — a major source of energy for your muscles and other tissues — enter your cells. Without enough insulin, your body begins to break down fat as fuel. This process produces a buildup of acids in the bloodstream called ketones, eventually leading to diabetic ketoacidosis if untreated. If you have diabetes or you're at risk of diabetes, learn the warning signs of diabetic ketoacidosis — and know when to seek emergency care. Symptoms Diabetic ketoacidosis signs and symptoms often develop quickly, sometimes within 24 hours. For some, these signs and symptoms may be the first indication of having diabetes. You may notice: Excessive thirst Frequent urination Nausea and vomiting Abdominal pain Weakness or fatigue Shortness of breath Fruity-scented breath Confusion More-specific signs of diabetic ketoacidosis — which can be detected through home blood and urine testing kits — include: High blood sugar level (hyperglycemia) High ketone levels in your urine When to see a doctor If you feel ill or stressed or you've had a recent illness or injury, check your blood sugar level often. You might also try an over-the-counter urine ketones testing kit. Contact your doctor immediately if: You're vomiting and unable to tolerate food or liquid Your blood sugar level is higher than your target range and doesn't respond to home treatment Your urine ketone level is moderate or high Seek emergency care if: Your blood sugar level is consistently higher than 300 milligrams per deciliter (mg/dL), or 16.7 mill Continue reading >>

Caution: Don’t Get Caught With Ketones

Caution: Don’t Get Caught With Ketones

Ketoacidosis is an extremely serious diabetic complication that can lead to coma and even death. Unfortunately it is also fairly common. The good news, however, is that with proper care and an eye towards prevention, this costly and dangerous complication can be avoided. What Is Ketoacidosis? When there isn't enough insulin present for the metabolism of glucose, or when insufficient food has been eaten to satisfy energy requirements, the body burns fat for energy. Ketones are toxic, acidic byproducts of this process. Ketones are normally processed by the kidneys and excreted in the urine. But when more ketones are produced than the kidneys can handle, they can build up in the blood and lead to a dangerous condition known as diabetic ketoacidosis (DKA). Ketoacidosis raises the acidity of the body, which leads to "a cascade of problems throwing off a number a parameters in the body," says Cindy Onufer, RN, MA, CDE, the diabetes research and clinical care coordinator at Oregon Health Sciences University. Ketoacidosis rarely occurs in people with type 2 diabetes, who usually do not suffer from insufficiency of insulin, but is of great concern to those with type 1 diabetes. In fact, ketoacidosis is the number one cause of hospitalization for children with known diabetes in the United States. However, these hospitalizations are completely preventable if a urine ketone test is done and a care provider is called when indicated, says H. Peter Chase, MD, with the Barbara Davis Center for Childhood Diabetes in Denver, Colorado. Timely testing and prevention are of utmost importance as the condition can cause coma and death if proper treatment is not administered quickly. Higher ketone levels are a warning sign that your diabetes is out of control or that you may be in danger of ke Continue reading >>

Is Ketosis Dangerous?

Is Ketosis Dangerous?

You may have heard from your doctor that ketosis is a life-threatening condition. If so, your doctor is confusing diabetic ketoacidosis (DKA) with nutritional ketosis, or keto-adaptation. First, some semantics. Our body can produce, from fat and some amino acids, three ketone bodies (a “ketone” refers to the chemical structure where oxygen is double-bonded to carbon sandwiched between at least 2 other carbons). These ketone bodies we produce are: acetone, acetoacetone, and beta-hydroxybutyrate (B-OHB). [For anyone who is interested, they are the 3 most right structures on the figure, below.] Why do we make ketones? For starters, it’s a vital evolutionary advantage. Our brain can only function with glucose and ketones. Since we can’t store more than about 24 hours’ worth of glucose, we would all die of hypoglycemia if ever forced to fast for more than a day. Fortunately, our liver can take fat and select amino acids (the building blocks of proteins) and turn them into ketones, first and foremost to feed our brains. Hence, our body’s ability to produce ketones is required for basic survival. What is diabetic ketoacidosis? When diabetics (usually Type I diabetics, but sometimes this occurs in very late-stage, insulin-dependent, Type II diabetics) fail to receive enough insulin, they go into an effective state of starvation. While they may have all the glucose in the world in their bloodstream, without insulin, they can’t get any into their cells. Hence, they are effectively going into starvation. The body does what it would do in anyone – it starts to make ketones out of fat and proteins. Here’s the problem: the diabetic patient in this case can’t produce any insulin, so there is no feedback loop and they continue to produce more and more ketones withou Continue reading >>

Clinical Profile And Outcomes Of Paediatric Patients With Diabetic Ketoacidosis At A Tertiary Care Hospital In Pakistan

Clinical Profile And Outcomes Of Paediatric Patients With Diabetic Ketoacidosis At A Tertiary Care Hospital In Pakistan

Clinical profile and outcomes of paediatric patients with diabetic ketoacidosis at a tertiary care hospital in Pakistan Madiha Syed, Abdul Rashid, Khadija Nuzhat Humayun ( Department of Paediatrics and Child Health, Aga Khan University, Stadium Road, Karachi, Pakistan. ) Fariha Batool Khawaja, Taimur Saleem, Umair Khalid ( Medical Graduates, Class of 2009, Aga Khan University, Stadium Road, Karachi, Pakistan. ) Objectives: This study aims to present an experience in the management and clinical features of 88 children presenting with diabetic ketoacidosis (DKA) from Pakistan. Methods: A retrospective medical chart review of all patients, < 15 years of age, who presented to the Aga Khan University Hospital, Karachi, Pakistan in the last ten years with a diagnosis of diabetic ketoacidosis was carried out. Severity of DKA was defined as mild (venous pH<7.30 or bicarbonate=15mEq/l), moderate (venous pH<7.2 or bicarbonate= 10 mEq/l) and severe (venous pH <7 or bicarbonate < 5 mEq/l). These classes correspond to 1st, 2nd and 3rd degrees of diabetic ketoacidosis severity respectively. Cases in which diabetic ketoacidosis had occurred at onset of diabetic diagnosis were not included in the study. Results: Mean age was 7.5 3.6 years; 58 (66%) patients were male. Twenty six patients had mild diabetic ketoacidosis, 44 had moderate while 18 had severe diabetic ketoacidosis at the time of presentation. Severity of diabetic ketoacidosis was significantly associated with the presence of infection, history of omission of insulin, poor compliance, presence of shock at time of presentation, length of stay in the hospital, final outcome (p < 0.01 for each of these associations) and Glasgow Coma Scale score (p=0.02). Mortality in this series was 3.4%. Conclusion: Poor compliance was associ Continue reading >>

Diabetes Mellitus And Polyuria

Diabetes Mellitus And Polyuria

Diabetes comes from the Greek word which means “siphon”. There are two distinct disorders that share the first name diabetes: diabetes mellitus and diabetes insipidus. This is because both disorders cause polyuria, or excessive urine output. Diabetes insipidus is a disorder of urine concentration which we will discuss in spring quarter. Diabetes mellitus is a disorder of blood glucose regulation, which results from a deficiency in the action of the hormone insulin. This may be due to autoimmune destruction of the insulin-secreting cells of the pancreas (type 1 diabetes mellitus) or it may result from a problem in the responsiveness of tissues to insulin, known as insulin resitance (type 2 diabetes mellitus). With either disorder, the result is hyperglycemia, or high levels of glucose in the plasma. How does hyperglycemia cause excessive urine production? To answer this, we need to understand a little bit about how the kidney works. Each kidney contains about a million functional units called nephrons (blue structure in the figure). The first step in the production of urine is a process called filtration (green arrow). In filtration, there is bulk flow of water and small molecules from the plasma into Bowman’s capsule (the first part of the nephron). Because of the nonspecific nature of filtration, useful small molecules such as glucose, amino acids, and certain ions end up in the forming urine, which flows into the kidney tubules. To prevent the loss of these useful substances from the body, the cells lining the kidney tubules use epithelial transport to transfer these substances out of the forming urine and back into the extracellular fluid. This process is known as reabsorption (purple arrows). Under normal circumstances, 100% of the glucose that is filtered is Continue reading >>

Dka | Ditch Medics

Dka | Ditch Medics

* DKA is a problem ofinsufficient(or inefficient) insulin * Problems with DKA are characterized by dehydration, acidosis, and relative hypokalemia. * Maintaining elevated minute ventilation is critical for managing DKA patients requiring airway management or respirtory support * Treatment is focused on fixing dehydration and correcting acidosis. Aggressive fluid resuscitation is indicated. Titration of insulin administration to fix acid-base imbalance and hyperglycemia, while preventing treatment related complications is the key. I remember learning about diabetic ketoacidosis (DKA) in my medic schoolin. Kind of. Sort of. Ok, actually I remember hearing about DKA but not really learning much. It has something to do with high blood sugar. And they breathe really deep and fast. Ohtheir breath smells like Fruit Loops(or is it Fruity Pebbles?) Anyway, start an IV, give them some fluids and drive them to the hospital. Simple. As it turns out, DKA is an incredibly complex process. One that prehospital providers fail to understand properlyand need to understand properly. These patients are sick. Often really, really sick. DKA can be a common problem to come across in the EMS/emergency medical world. Its critical you understand pathology and treatment strategy for DKA. Lets review. DKA is a problem of insulin. It primarily effects type 1 diabetics (insulin deficient) but can present in type 2 diabetics (insulin resistant) with an associated triggering factor. Often, DKA is the first symptom of previously undiagnosed diabetes but most frequently occurs in known diabetics. The primary presentation of DKA involves a lack of insulin, in addition to a rise in glucagon, causing blood glucose level to precipitously rise. Glucose molecules are highly osmotic. So they pull fluid from e Continue reading >>

Diagnosis And Treatment Of Diabetic Ketoacidosis And The Hyperglycemic Hyperosmolar State

Diagnosis And Treatment Of Diabetic Ketoacidosis And The Hyperglycemic Hyperosmolar State

Diagnosis and treatment of diabetic ketoacidosis and the hyperglycemic hyperosmolar state Jean-Louis Chiasson, Nahla Aris-Jilwan, Raphal Blanger, Sylvie Bertrand, Hugues Beauregard, Jean-Marie ko, Hlne Fournier and Jana Havrankova DIABETIC KETOACIDOSIS AND THE HYPERGLYCEMIC hyperosmolar state are the most serious complications of diabetic decompensation and remain associated with excess mortality. Insulin deficiency is the main underlying abnormality. Associated with elevated levels of counterregulatory hormones, insulin deficiency can trigger hepatic glucose production and reduced glucose uptake, resulting in hyperglycemia, and can also stimulate lipolysis and ketogenesis, resulting in ketoacidosis. Both hyperglycemia and hyperketonemia will induce osmotic diuresis, which leads to dehydration. Clinical diagnosis is based on the finding of dehydration along with high capillary glucose levels with or without ketones in the urine or plasma. The diagnosis is confirmed by the blood pH, serum bicarbonate level and serum osmolality. Treatment consists of adequate correction of the dehydration, hyperglycemia, ketoacidosis and electrolyte deficits. Continue reading >>

The Paleo Guide To Ketosis

The Paleo Guide To Ketosis

Ketosis is a word that gets tossed around a lot within the Paleo community – to some, it’s a magical weight-loss formula, to others, it’s a way of life, and to others it’s just asking for adrenal fatigue. But understanding what ketosis really is (not just what it does), and the physical causes and consequences of a fat-fueled metabolism can help you make an informed decision about the best diet for your particular lifestyle, ketogenic or not. Ketosis is essentially a metabolic state in which the body primarily relies on fat for energy. Biologically, the human body is a very adaptable machine that can run on a variety of different fuels, but on a carb-heavy Western diet, the primary source of energy is glucose. If glucose is available, the body will use it first, since it’s the quickest to metabolize. So on the standard American diet, your metabolism will be primarily geared towards burning carbohydrates (glucose) for fuel. In ketosis, it’s just the opposite: the body primarily relies on ketones, rather than glucose. To understand how this works, it’s important to understand that some organs in the body (especially the brain) require a base amount of glucose to keep functioning. If your brain doesn’t get any glucose, you’ll die. But this doesn’t necessarily mean that you need glucose in the diet – your body is perfectly capable of meeting its glucose needs during an extended fast, a period of famine, or a long stretch of very minimal carbohydrate intake. There are two different ways to make this happen. First, you could break down the protein in your muscles and use that as fuel for your brain and liver. This isn’t ideal from an evolutionary standpoint though – when you’re experiencing a period of food shortage, you need to be strong and fast, Continue reading >>

These Word Parts Provide The Basic Meanings For Medical Terms. They Can Be Used Alone Or Can Be Joined With A Prefix, A Suffix, Or Both.

These Word Parts Provide The Basic Meanings For Medical Terms. They Can Be Used Alone Or Can Be Joined With A Prefix, A Suffix, Or Both.

Root Words – Medical Terminology Example 1: (A root word with no prefix or suffix.) The root word "plasma" means a semi-liquid form found in cells. Example 2:(A prefix and root word conjoined.) The prefix dys- means painful and root word "uria" means urine, together they form the medical term "dysuria" which mean "painful or difficult urination. Example 3: (A root word and suffix conjoined.) The root word dermat means skin, the suffix ology means the study of, together they form the medical term "dermatology" which means "to study the skin". Example 4:(A prefix, root word, and suffix conjoined.) The prefix leuko means white, the root word cyte means cell, and the suffix osis means a condition of. Together these word parts form the term "leukocytosis", which means "a condiotion of elevated white blood cells". · Root word: Acanth(o) Meaning: Spiny, thorny Example: acanthion - the tip of the anterior nasal spine · Root word: Actin(o) Meaning: Light Example: Actinotherapy - ultraviolet light therapy used in dermatology · Root word: Aer(o) Meaning: Air, gas Example: Aerosol - liquid or particulate matter dispersed in air, gas, or vapor form · Root word: Alge, algesi, algio, algo Meaning: Pain Example: Analgesic - a pain reducing agent · Root word: Amyl(o) Meaning: Starch Example: Amylolysis - hydrolysis of starch unto soluable products · Root words: Andro Meaning: Masculine Example: Androsterone - a steroid metabolite found in male urine · Root words: Athero Meaning: Plaque, fatty substance Example: Atheroembolism - cholesterol embolism originating from an atheroma · Root qord: Bacill(i) Meaning: Bacilli, bacteria Example: Bacillemia - presence of bacilli in the blood · Root word: Bacteri(o) Meaning: Bacteria Example: Bacteriocin - a protien Continue reading >>

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