Acute Complications Management Flashcards
7 cards from real Diabetes practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Acute Complications Management flashcards as text
A patient presents with DKA and an initial serum potassium of 3.1 mEq/L. What should be done before starting insulin therapy?
Answer: Replace potassium to at least 3.5 mEq/L before initiating insulin
Insulin therapy in the setting of hypokalemia can precipitate life-threatening arrhythmias; potassium must be repleted to ≥3.5 mEq/L before insulin is started.
A parent calls reporting their 9-year-old with type 1 diabetes has glucose of 320 mg/dL, is vomiting, and appears lethargic. What is the most appropriate instruction?
Answer: Go to the emergency department immediately
A child with hyperglycemia, vomiting, and lethargy requires immediate emergency evaluation for DKA, as pediatric DKA can deteriorate rapidly.
Which statement about sodium bicarbonate use in DKA is correct according to current guidelines?
Answer: It is recommended only when arterial pH is below 6.9 due to lack of proven benefit and potential harm at higher pH
Current ADA guidelines reserve bicarbonate therapy for severe acidosis (pH <6.9) because routine use has not been shown to improve outcomes and may worsen hypokalemia.
A patient with type 2 diabetes is started on regular insulin via IV infusion for HHS. The glucose drops from 720 to 260 mg/dL over 4 hours. What is the next appropriate step?
Answer: Add dextrose to IV fluids and continue insulin at a reduced rate
When glucose reaches approximately 250–300 mg/dL in HHS, dextrose is added to IV fluids and insulin is reduced to maintain glucose at 250–300 mg/dL until osmolality normalizes.
A patient with recurrent severe hypoglycemia is being evaluated. Which intervention has been shown to most effectively restore hypoglycemia awareness?
Answer: Strict avoidance of hypoglycemia for several weeks
Meticulously avoiding hypoglycemic episodes for 2–3 weeks can restore counter-regulatory hormone responses and hypoglycemia awareness in many patients.
Which of the following is the recommended glucose target range during treatment of DKA with continuous insulin infusion?
Answer: 150–200 mg/dL until anion gap closes
The target glucose during DKA insulin infusion is 150–200 mg/dL; dextrose is added to IV fluids at 250 mg/dL to maintain this range while continuing insulin until anion gap closes.
A patient who successfully treated mild hypoglycemia at home with juice now has a glucose of 310 mg/dL one hour later. What is the most likely explanation?
Answer: Over-treatment of hypoglycemia with excess carbohydrates causing rebound hyperglycemia
Over-treating hypoglycemia with excessive carbohydrates ('eating everything in sight') is the most common cause of rebound hyperglycemia after hypoglycemic episodes.