Which of the following are key differences between diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic state (HHS)? (Select all that apply).
Blood glucose levels in DKA are typically higher than in HHS
DKA involves significant ketosis and metabolic acidosis, while HHS typically does not
DKA is more common in type 1 diabetes, while HHS is more common in type 2 diabetes
None of the above
HHS patients often have more severe dehydration than DKA patients
Correct Answer : A,B,C,E
A. Blood glucose levels in DKA are typically higher than in HHS: In fact, HHS usually presents with higher blood glucose levels than DKA—often exceeding 600 mg/dL, while DKA typically ranges from 250 to 600 mg/dL.
B. DKA involves significant ketosis and metabolic acidosis, while HHS typically does not: DKA is characterized by the breakdown of fats into ketones, leading to metabolic acidosis. HHS typically lacks significant ketosis because insulin levels, while low, are still sufficient to suppress ketogenesis.
C. DKA is more common in type 1 diabetes, while HHS is more common in type 2 diabetes: DKA usually occurs in individuals with type 1 diabetes due to absolute insulin deficiency. HHS is more often seen in type 2 diabetics who still produce some insulin but not enough to prevent severe hyperglycemia and dehydration.
D. None of the above: This choice is incorrect, as B, C, and E are valid differences between DKA and HHS.
E. HHS patients often have more severe dehydration than DKA patients: HHS leads to profound osmotic diuresis over a longer period, causing extreme dehydration. DKA progresses faster but with less total fluid loss compared to HHS.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["B","C","E"]
Explanation
A. Itching: Pruritus typically develops during the icteric phase of hepatitis when bilirubin accumulates in the tissues. It is not considered an early or prodromal symptom but occurs later as jaundice becomes evident.
B. Vomiting: Nausea and vomiting are common prodromal symptoms of hepatitis due to liver inflammation and its impact on digestion. These gastrointestinal symptoms often occur before jaundice or other late signs become apparent.
C. Fatigue: Fatigue is one of the most frequently reported early symptoms of hepatitis. It results from the body's immune response and reduced liver function and may begin days or weeks before jaundice or dark urine appears.
D. Jaundice: Jaundice typically marks the transition to the icteric phase of hepatitis and follows the prodromal phase. It appears as liver dysfunction progresses and bilirubin accumulates in the bloodstream and tissues.
E. Hyperalgia (increased sensitivity to pain): Increased pain sensitivity, particularly in the upper right quadrant, can occur early in hepatitis due to liver inflammation. This symptom may accompany general malaise and precedes more visible signs like jaundice.
Correct Answer is ["A","B","C"]
Explanation
A. Clinical manifestations: hematuria (urine is smoky, brown tinged): Hematuria is a hallmark sign of acute glomerulonephritis. The smoky or cola-colored urine results from red blood cells leaking through the damaged glomeruli, often seen in post-infectious cases.
B. Clinical manifestations: oliguria: Decreased urine output is common due to impaired glomerular filtration. Oliguria reflects reduced kidney function, which contributes to fluid retention, hypertension, and accumulation of waste products.
C. Treatment: Antibiotics, corticosteroids, cytotoxic agents, anticoagulants: Depending on the cause and severity, treatment may include antibiotics for infection, corticosteroids or cytotoxic agents for inflammation, and anticoagulants if there's risk of thrombosis due to nephrotic syndrome features.
D. Treatment: Prescription dose ibuprofen: NSAIDs like ibuprofen are generally avoided in glomerulonephritis because they can reduce renal perfusion and worsen kidney injury, especially in patients already experiencing compromised kidney function.
E. Clinical manifestations: Proteinuria that exceeds 3–5g/day with albumin: This level of proteinuria is characteristic of nephrotic syndrome, not acute glomerulonephritis. While proteinuria may be present, it is typically moderate and not in the nephrotic range.
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