DKA And HHS MCQ: Diabetes Quiz!

2.

If sodium is < 140 mEq/L, you want to use:

0.45% NaCl
0.9% NaCl
Normosol R
Lactated Ringers

Correct Answer

A. 0.9% NaCl

Explanation

If the sodium level is less than 140 mEq/L, the most appropriate solution to use would be 0.9% NaCl. This solution, also known as normal saline, has a sodium concentration that is closer to the normal physiological range of sodium in the body. It can help restore the sodium balance and correct the low sodium levels more effectively compared to the other options listed.

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2

3.

An animal that is eating and not vomiting with DKA can be dosed with insulin and monitored at home.

True
False

Correct Answer

A. True

Explanation

This statement is true because DKA (diabetic ketoacidosis) is a serious condition that occurs when the body doesn't have enough insulin to break down glucose for energy, so it starts to break down fat instead. In animals with DKA, insulin administration is necessary to regulate blood sugar levels. If the animal is eating and not vomiting, it indicates that it is stable enough to receive insulin and be monitored at home. However, close monitoring is still required to ensure that the animal's condition improves and that there are no complications.

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1

4.

Insulin should not be given SQ to dehydrated animals.

True
False

Correct Answer

A. True

Explanation

Insulin should not be given subcutaneously (SQ) to dehydrated animals because it can worsen their dehydration. Insulin helps regulate blood sugar levels by promoting the uptake of glucose into cells. However, it also promotes the movement of water into cells, which can exacerbate dehydration in animals that are already dehydrated. Therefore, it is important to rehydrate the animal before administering insulin to prevent further complications.

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1

5.

Phosphorous behaves similarly to K.

True
False

Correct Answer

A. True

Explanation

Phosphorous behaves similarly to K because both elements belong to the same group in the periodic table, Group 15. Group 15 elements, also known as the nitrogen group, share similar chemical properties due to having the same number of valence electrons. Therefore, they exhibit similar behaviors in chemical reactions and can form compounds with similar characteristics.

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6.

If sodium is >155 mEq/L use:

Normosol R
0.9% NaCl
0.45% NaCl
Lactated Ringers

Correct Answer

A. 0.45% NaCl

Explanation

If the sodium level is greater than 155 mEq/L, the appropriate solution to use would be 0.45% NaCl. This solution has a lower sodium concentration compared to the other options listed, making it the best choice to help lower the sodium level in the body.

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1

7.

In DKA, Na follows what out of the body?

K
Ca
Ketones
PO4

Correct Answer

A. Ketones

Explanation

In diabetic ketoacidosis (DKA), the body is unable to use glucose for energy, so it starts breaking down fat instead. This process produces ketones as a byproduct. Ketones are acidic and can build up in the blood, leading to a dangerous condition. Therefore, in DKA, the body tries to eliminate ketones by excreting them through urine. Na (sodium) does not follow ketones out of the body; instead, it plays a role in maintaining fluid balance, nerve function, and muscle contraction.

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3

8.

Bicarb should be given to DKA animals.

True
False

Correct Answer

A. False

Explanation

Bicarb should not be given to animals with diabetic ketoacidosis (DKA) because it can worsen the condition. DKA is characterized by high levels of ketones and acid in the blood, and bicarb can further increase the blood pH, leading to a shift in the balance between ketones and bicarbonate. This can result in a decrease in the body's ability to clear ketones and exacerbate the acidosis. Therefore, bicarb administration is not recommended in DKA animals.

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2

9.

What can be added to urine if a ketone strip is negative?

Insulin
Glucose
Hydrogen peroxide
Dextrose

Correct Answer

A. Hydrogen peroxide

Explanation

Hydrogen peroxide can be added to urine if a ketone strip is negative. Ketone strips are used to detect the presence of ketones in urine, which can indicate a state of ketosis. If the strip is negative, it means that no ketones were detected. Adding hydrogen peroxide to the urine can help to enhance the reaction on the strip and potentially detect any trace amounts of ketones that may be present. Insulin, glucose, and dextrose are not typically added to urine in this context.

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1

10.

What sign leads to a diagnosis of DKA?

Correct Answer
Ketonuria

Explanation
Ketonuria is the presence of ketones in the urine, which indicates a diagnosis of diabetic ketoacidosis (DKA). DKA is a serious complication of diabetes that occurs when the body produces high levels of ketones due to a lack of insulin. Ketones are byproducts of the breakdown of fat for energy, and their presence in the urine suggests that the body is using fat instead of glucose for fuel. Therefore, the presence of ketonuria is a key sign that leads to a diagnosis of DKA.

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1

11.

If sodium is 140-155 mEq/L, you use:

Normosol R
0.9% NaCl
0.45% NaCl
Lactated Ringers

Correct Answer

A. Normosol R

Explanation

Normosol R is the correct answer because it is an isotonic solution that contains sodium in the range of 140-155 mEq/L. Isotonic solutions have the same concentration of solutes as the blood and are used to replace fluid and electrolyte losses in the body. Therefore, Normosol R would be the appropriate choice when the sodium level falls within the specified range.

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12.

DKA and HHS patients should be rehydrated quickly.

True
False

Correct Answer

A. False

Explanation

The statement is false because while both DKA (Diabetic Ketoacidosis) and HHS (Hyperosmolar Hyperglycemic State) patients require rehydration, the approach to rehydration differs. In DKA, rapid rehydration is not recommended as it can lead to cerebral edema. Instead, a more cautious approach is taken. In HHS, on the other hand, rapid rehydration is necessary to correct the severe dehydration and electrolyte imbalances.

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0

13.

To prevent worsening of hypokalemia:

Delay insulin for 1-2 hours more to allow fluids to replace K
Do not give insulin
Reduce initial insulin dose by 25-50% to dampen intracellular shift
Give equal amounts of glucose and K

Correct Answer(s)

A. Delay insulin for 1-2 hours more to allow fluids to replace K
A. Reduce initial insulin dose by 25-50% to dampen intracellular shift

Explanation

The correct answer is to delay insulin for 1-2 hours more to allow fluids to replace K and reduce the initial insulin dose by 25-50% to dampen intracellular shift. This is because hypokalemia is a condition characterized by low levels of potassium in the blood. Insulin can further lower potassium levels by promoting the movement of potassium into cells. By delaying insulin administration, it allows for the replacement of potassium through fluid intake. Additionally, reducing the initial insulin dose helps prevent excessive movement of potassium into cells, thereby preventing worsening of hypokalemia. Giving equal amounts of glucose and potassium is not the correct approach as it does not address the underlying cause of hypokalemia or prevent its worsening.

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14.

What are the main factors for development of HHS?

Decreased insulin utilization
Increased hepatic gluconeogenesis
Impaired renal excretion of glucose
Increased glucose consumption

Correct Answer(s)

A. Decreased insulin utilization
A. Increased hepatic gluconeogenesis
A. Impaired renal excretion of glucose

Explanation

The main factors for the development of hyperosmolar hyperglycemic state (HHS) include decreased insulin utilization, increased hepatic gluconeogenesis, and impaired renal excretion of glucose. HHS occurs when there is a relative insulin deficiency, leading to decreased utilization of glucose by cells. This results in increased hepatic gluconeogenesis, where the liver produces more glucose. Additionally, impaired renal excretion of glucose further contributes to the elevated blood glucose levels seen in HHS. Increased glucose consumption is not a factor in the development of HHS.

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15.

DKA animals should be started on insulin in what time period?

Correct Answer(s)
1-2 hours
1 or 2 hours
One to two hours

Explanation
DKA stands for diabetic ketoacidosis, a serious complication of diabetes. In DKA, the body starts breaking down fat for energy instead of glucose, leading to the production of ketones and a decrease in insulin levels. Insulin therapy is crucial in treating DKA as it helps to lower blood glucose levels and prevent further ketone production. Therefore, animals with DKA should be started on insulin within the time period of 1-2 hours, 1 or 2 hours, or one to two hours to effectively manage their condition.

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DKA And HHS MCQ: Diabetes Quiz!

In DKA the body pulls extra H inside the cells and pushed K out.

Quiz Preview

If sodium is < 140 mEq/L, you want to use:

An animal that is eating and not vomiting with DKA can be dosed with insulin and monitored at home.

Insulin should not be given SQ to dehydrated animals.

Phosphorous behaves similarly to K.

If sodium is >155 mEq/L use:

In DKA, Na follows what out of the body?

Bicarb should be given to DKA animals.

What can be added to urine if a ketone strip is negative?

What sign leads to a diagnosis of DKA?

If sodium is 140-155 mEq/L, you use:

DKA and HHS patients should be rehydrated quickly.

To prevent worsening of hypokalemia:

What are the main factors for development of HHS?

DKA animals should be started on insulin in what time period?