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

Answer and Explanation

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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Correct Answer is ["A","B","C"]

Explanation

A. Renal agenesis: failure of an organ (renal) to develop: Renal agenesis is the complete absence of one or both kidneys due to failure of development during fetal life. Bilateral agenesis is often fatal, while unilateral agenesis can be asymptomatic if the remaining kidney functions well.

B. Renal hypoplasia: failure of kidney to develop to normal size and contains fewer renal lobes: In renal hypoplasia, the kidney is structurally normal but smaller than average and contains fewer nephrons or lobes. This congenital condition may be unilateral and asymptomatic or bilateral and lead to renal insufficiency.

C. Renal dysgenesis: failure of an organ (kidney) to develop normally: Renal dysgenesis refers to abnormal development of the kidney structure, resulting in malformations that can impair function. It often involves malformed or nonfunctional renal tissue.

D. Renal dysgenesis: failure of an organ (kidney) to develop: This description better defines renal agenesis rather than dysgenesis, which implies abnormal rather than absent development.

A. Transient Ischemic Attack (TIA) B. Hemorrhagic Stroke C. Severe vision loss in both eyes D. Sudden loss of consciousness E. Sudden severe headache with vomiting F. Ischemic Stroke G. Sudden weakness or numbness, often on one side of the body

Correct Answer is ["A","G"]

Explanation

A. Transient Ischemic Attack (TIA): A TIA presents with stroke-like symptoms that resolve within minutes to hours without permanent damage. Ms. Lauren’s symptom resolution within 6 hours and return to baseline strongly suggests a TIA. Prompt recognition is essential, as TIAs are often precursors to future strokes and require further evaluation.

B. Hemorrhagic Stroke: Hemorrhagic strokes typically present with sudden, severe symptoms such as intense headache, vomiting, or rapid loss of consciousness. These symptoms usually do not resolve quickly. Ms. Lauren’s gradual symptom resolution and stable vital signs are not consistent with this type of stroke.

C. Severe vision loss in both eyes: While visual disturbances can occur during strokes, bilateral severe vision loss is less common and would typically be seen in strokes involving the occipital lobes or vertebrobasilar system. Ms. Lauren’s case does not provide evidence of this symptom, hence an unlikely feature here.

D. Sudden loss of consciousness: Loss of consciousness is more common in massive strokes, particularly hemorrhagic ones or those involving the brainstem. Ms. Lauren remained awake and was able to report symptoms and anxiety, which rules out this presentation.

E. Sudden severe headache with vomiting: This symptom combination is more typical of a hemorrhagic stroke or subarachnoid hemorrhage. Ms. Lauren did not report a headache or vomiting, which makes this an unlikely symptom in her current presentation.

F. Ischemic Stroke: Ischemic strokes result in prolonged neurological deficits lasting more than 24 hours. Since Ms. Lauren’s symptoms are resolving within a short window and she is returning to baseline, this is less likely than a TIA in her situation.

G. Sudden weakness or numbness, often on one side of the body: This is a hallmark sign of a TIA or stroke. Ms. Lauren’s initial symptoms were stroke-like and likely included unilateral weakness or numbness, which are classic indicators of a TIA.

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Which of the following are key differences between diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic state (HHS)? (Select all that apply).

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Naxlex Comprehensive Predictor Exams

Which of the following are the correct statements? (Select all that apply)

Correct Answer is ["A","B","C"]

Explanation

Correct Answer is ["A","G"]

Explanation

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