With respect to laboratory findings in diabetic ketoacidosis (DKA) and hyperglycemic hyperosmolar nonketotic coma (HHNC), all of the following guidelines
... [Show More] are generally true EXCEPT:
Answers:
1.Patients with HHNC typically have blood glucose > 700 mg/dL, whereas patients with DKA have blood glucose > 350 mg/dL.
2.Serum ketones are present in patients with DKA but not usually in patients with HHNC.
3.Serum bicarbonate is typically severely low (<10mEq) in patients with either DKA or HHNC
4.Serum osmolality in patients with HHNC is typically > 350 mOsm/L.
5.BUN is elevated more in patients with HHNC (>50 mg/dL) than in patients with DKA (25-50 mg/dL).
3.Serum bicarbonate is typically severely low (<10mEq) in patients with either DKA or HHNC
In a 70kg male DKA patient with serum glucose of 573 mg/dL, all of the following statements with regard to fluid and electrolyte imbalances are true EXCEPT:
Answers:
1.Total body water deficit is approximately 5L.
2.Serum sodium of 129 mEq represents dilutional hyponatremia and the corrected value is approximately 137 mEq.
3.Despite a serum potassium level of 4.8 mEq, the patient is probably total body potassium depleted.
4.The patient is likely to be total body phosphorus depleted.
5.A normal magnesium level is reassuring and obviates the need for magnesium replacement.
5.A normal magnesium level is reassuring and obviates the need for magnesium replacement.
Regarding the treatment of hyperosmolar hypertonic nonketotic coma (HHNC) and its associated symptoms, which of the following is correct:
Answers:
1.Half of the fluid deficit should be corrected over the first hour and the remainder over the following 8 hours.
2.Since patients are not acidotic, close monitoring of glucose is not necessary.
3.Hyperosmolarity should be corrected within the first few hours in the emergency department.
4.Phenytoin (Dilantin) is often ineffective for seizures associated with HHNC.
5.In HHNC patients with severe dehydration, bleeding diathesis is a major clinical concern.
4.Phenytoin (Dilantin) is often ineffective for seizures associated with HHNC.
Regarding the development of cerebral edema in patients being treated for DKA, all of the following are true EXCEPT:
Answers:
1.Cerebral edema typically occurs six to ten hours following onset of treatment.
2.Children have a higher incidence of cerebral edema.
3.Mannitol and steroids should be administered immediately to any patient suspected of developing cerebral edema.
4.Mortality of patients developing cerebral edema is 90%.
5.Patients with serum glucose below 250 mg/dL still being treated with insulin are most likely to develop clinically evident cerebral edema.
3.Mannitol and steroids should be administered immediately to any patient suspected of developing cerebral edema.` [Show Less]