Case DKA Flashcards
1
Q
What is the triad of diabetic ketoacidosis?
A
- Hyperglycemia
- Ketosis
- Metabolic acidosis
2
Q
What is the pathophysiology of diabetics ketoacidosis?
A
Insulin deficiency
Counterregulatory hormone excess
3
Q
what are the s/s in DKA? Nausea vomiting Thirst polyuria Abdominal pain Shortness of breath
Inadequate insulin Infection Infarction Drugs Pregnancy
PE: Tachycardia Hypotension Abdominal tenderness Dec sensorium?
A
Abdominal pain (imitating acute pancreatitis)
4
Q
What are the tests that we are going to order in DKA?
A
CBG Serum ketones ABGs Check electrolytes: Na Cl K phos Mg
Look for precipitating cause of DKA: Chest X-ray CBC Hb: Hct: WBC: N- L- M- E- Plt: Urinalysis Lipase
5
Q
Management of DKA
A
Conform diagnosis Admit ICU if pH<7 dec sensorium Asses: electrolytes Renal function Crea
1) replace fluids
2-3 L of 0.9% sakin over 1-3 h (10-20 ml/kg/hr)
0.45% saline at 250-500 ml/hr
6
Q
41 yr old male with accidentally discovered adrenal mass. When to investigate? How?
A
> 1 cm investigate 1) screen for hormone excess Plasma metanephrine S 24h cortisol Plasma aldosterone and renin
