HHS

Question 1

Define HHS

Answer 1

A chronic metabolic disorder characterised by the impaired secretion and resistance of insulin, resulting in elevated blood glucose levels.

Question 2

What happens to the cells in HHS?

Answer 2

The body’s cells are resistant to the effects of insulin, leading to an inability to efficiently use glucose for energy.

Question 3

how does the pancreas contribute to HHS?

Answer 3

The pancreas may not produce enough insulin to overcome insulin resistance. This contributes to the persistent elevation of blood sugar levels.

Question 4

How is HHS characterised?

Answer 4

by extreme dehydration.
The high levels of glucose in the blood lead to osmotic diuresis, causing excessive fluid loss.

Question 5

what does the hyperosmolality in HHS cause?

Answer 5

Excessive loss of fluids results in increased blood concentration, causing hyperosmolality, leading to altered mental symptoms

Question 6

what process contributes to elevated blood glucose?

Answer 6

Glycogenolysis Inhibition: Decreased glycogenolysis contributes to elevated blood glucose levels.

Question 7

in what scenarios does HHS often occur?

Answer 7

HHS often occurs in the setting of an underlying illness or stressors such as infections, heart attacks, or other medical conditions that can exacerbate insulin resistance.

Question 8

what are the signs of HHS?

Answer 8

• Reduced GCS
  -Dehydration
  -Hemiparesis (can be confused for a stroke)
  -Seizures

Question 9

What are the symptoms of HHS?

Answer 9

• Generalised weakness and leg cramps
  -Confusion, hallucinations, headaches Visual disturbance
  -Polyuria and polydipsia
  -Nausea, vomiting and abdominal pain

Question 10

What is the treatment for HHS?

Answer 10

• IV fluid 0.9% saline
  -IV insulin only if there is ketonaemia or IV fluids aren’t working
  -LMWH to anticoagulate patient as they have thicker blood
  -Electrolytes lost (K+)

Question 11

What are the cardiovascular complications of HHS?

Answer 11

Venous Thromboembolism, Arrhythmias, MI

Question 12

What are the neuro complications of HHS?

Answer 12

strokes and seizures

Question 13

What are the renal complications of HHS?

Answer 13

AKI