Endocrine & metabolic · UKMLA & AKT
Hyperosmolar hyperglycaemic state (HHS)
A free high-yield preview for the UKMLA Applied Knowledge Test. Below are the key points to recognise hyperosmolar hyperglycaemic state (hhs) — the full SA Note notes add investigations, management, complications and 10 practice questions.
Key high-yield points
- Blood glucose >30 mmol/L
- Serum osmolality >320 mOsm/kg - formula: 2(Na + K) + glucose + urea
- Serum bicarbonate >15 mmol/L and/or pH >7.3 (no significant acidosis)
- Ketones absent or minimal (<3 mmol/L; urine ketones ≤2+)
- Typically type 2 diabetes; may be first presentation in up to 25% of cases
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