This topic contains a solution. Click here to go to the answer

Author Question: Describe the metabolic events that result in the signs and symptoms associated with DKA. Was Matias ... (Read 108 times)

rosent76

  • Hero Member
  • *****
  • Posts: 516
Describe the metabolic events that result in the signs and symptoms associated with DKA. Was Matias in this state when he was admitted? What precipitating factors may lead to DKA?
 
  What will be an ideal response?

Question 2

Describe the metabolic events that led to Matias's symptoms and subsequent admission to the ER (polyuria, polydipsia, polyphagia, fatigue, and weight loss), integrating the pathophysiology of T1DM into your discussion.
 
  What will be an ideal response?



Related Topics

Need homework help now?

Ask unlimited questions for free

Ask a Question
Marked as best answer by a Subject Expert

Shshxj

  • Sr. Member
  • ****
  • Posts: 335
Answer to Question 1

 The symptoms associated with DKA include: polydipsia, polyuria, polyphagia, weakness, lethargy, abdominal pain, malaise, and headaches/dizziness. Additionally, common symptoms also include:
Kussmaul breathing
Hypothermia, hyperapnea
Acetone breath
Poor skin turgor
Orthostatic hypotension
Mental status changes
 DKA is a severe form of hyperglycemia because when insulin is not being produced, certain metabolic events occur:
Glucose production via gluconeogenesis in the liver is not suppressed, contributing to high blood glucose levels.
Lipolysis occurs since insulin is not there to favor triglyceride storage, which alters fat metabolism. The increased rate of fatty acid metabolism results in ketosis.
Glucose and ketones accumulate in the blood, which causes osmotic diuresis leading to increased urine production in an attempt to rid the body of excess ketones and glucose (polyuria).
Osmotic diuresis results in dehydration and electrolyte imbalance. Dehydration results in poor skin turgor and orthostatic hypotension due to a decreased blood volume.
DKA is a metabolic acidosis condition due to the high levels of serum ketones. Kussmaul breathing represents the body's attempt to correct this acidosis. The release of ketones can be noted in the acetone breath.
 Precipitating factors for DKA include:
Illness/infection
Inadequate insulin dosage
Initial manifestation of type 1 diabetes
Emotional/physical stress
 Yes, Matias was most likely in a DKA state upon admission because he had several of the signs and symptoms of DKA:
Altered mental changes (he was unconscious)
Extremely high blood glucose level (683 mg/dL)
He was recently fighting off a virus, which is a precipitating factor for DKA
He is dehydrated because his osmolality is high (his daily alcohol consumption may have contributed, too)
Electrolyte imbalances: sodium and phosphate are both low
High levels of CO2, which is a sign of excess acid in the body
Orthostatic hypotension; his blood pressure is low due to a decreased blood volume
Ketones and glucose in the urine (confirms that ketones are being produced via incomplete fatty acid metabolism)

Answer to Question 2

 With type 1 diabetes, insulin is not being produced because of the autoimmune destruction of beta cells within the pancreas.
 Without insulin, hepatic gluconeogenesis is not suppressed properly, leading to an increase in gluconeogenesis along with glycogenolysis. This causes hyperglycemia, a hyperosmolar condition.
 Without insulin, glucose cannot be transported into the cell, also resulting in hyperglycemia. Lack of nutrients results in polyphagia, or excessive hunger.
 Since hyperglycemia is a hyperosmolar condition, water is drawn from the cells into the blood in an attempt to compensate for the serum hyperosmolality. The cells become dehydrated, which contributes to polydipsia, or excessive thirst.
 The increase in urinary glucose excretion occurs due to a blood glucose concentration of 180 mg/dL or higher and water follows it (due to the osmotic gradient). This increases urination and manifests itself as polyuria.
 Because the cells are not getting the nutrients they need due to a lack of insulin, unintentional weight loss typically occurs in type




rosent76

  • Member
  • Posts: 516
Reply 2 on: Aug 21, 2018
Gracias!


Dominic

  • Member
  • Posts: 328
Reply 3 on: Yesterday
Wow, this really help

 

Did you know?

The National Institutes of Health have supported research into acupuncture. This has shown that acupuncture significantly reduced pain associated with osteoarthritis of the knee, when used as a complement to conventional therapies.

Did you know?

Famous people who died from poisoning or drug overdose include, Adolf Hitler, Socrates, Juan Ponce de Leon, Marilyn Monroe, Judy Garland, and John Belushi.

Did you know?

Patients should never assume they are being given the appropriate drugs. They should make sure they know which drugs are being prescribed, and always double-check that the drugs received match the prescription.

Did you know?

There are over 65,000 known species of protozoa. About 10,000 species are parasitic.

Did you know?

Thyroid conditions may make getting pregnant impossible.

For a complete list of videos, visit our video library