Diabetic Ketoacidosis (DKA)

Diabetic Ketoacidosis (DKA) Physiology: Hyperglycemia: ➧ Increased hepatic production of glucose. ➧ Diminished glucose uptake by peripheral tissues. ➧ Insulinopenia / Hyperglucagonemia. Ketoacidemia: ➧ The ketoacid is acetoacetic acid. The byproduct is acetone. The non-keto-acid is beta-hydroxybutyric acid. ➧ Increased lipolysis and hepatic ketogenesis ➧...

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Hypoglycemic Coma

Hypoglycemic ComaHypoglycemia in Type I DM: ➧ Common in patients intensively controlled with insulin. ➧ Asymptomatic blood glucose levels of < 50 mg/dL occur daily in up to 56% of patients. ➧ Symptomatic hypoglycemia occurs 2X/week on average. Severe Hypoglycemia: ➧ An episode requires intervention by another person for the patient to recover function. Causes of...

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Acute Hypocalcemia

Acute Hypocalcemia Causes: 1-Hypoparathyroidism ➧ Destruction of parathyroids (most commonly surgical – parathyroid resection or accidental). ➧ Acute hypomagnesemia 2-Reduced 1,25 (OH) vit D 3-Chronic renal insufficiency ➧ Acute systemic illness ➧ Drugs: ketoconazole, doxorubicin, cytarabine ➧ Increased uptake of Ca in bone ➧ Osteoblastic metastases ➧ Hungry...

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Acute Hypercalcemia

Acute Hypercalcemia Most Common Causes: 1-Endocrine: ➧ Hyperparathyroidism ➧ MEN ➧ PTH-related peptide (PTHrP) by solid tumors 2-Neoplastic: ➧ Ca with bone metastases ➧ Myeloma 3-Granulomatous: ➧ Sarcoidosis  ➧ Tuberculosis Clinical picture: ➧ History of polyuria and polydipsia  ➧ Dehydration ➧ Bone pain ➧ Confusion ➧ Anorexia  ➧...

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