Diabetes and Mx

Question 1

Management principles of DKA (4)

Answer 1

Rehydration
Insulin therapy
Correct electrolyte imbalances (K+)
Search for underlying cause

Question 2

When do you give HCO3- to correct acidosis?

Answer 2

Only in SEVERE acidosis (pH

Question 3

What do you use to resuscitate a pt in hyperosmolar state?

Answer 3

Rx 2L of hypotonic saline (0.45%)

Question 4

What are the expected potassium levels in DKA?

Answer 4

High due to acidosis shifting K out of cells, although can vary according to body stores

Question 5

What underlying cause of DKA should be suspected with a long history of Diabetes?

Answer 5

Silent AMI

Question 6

‘The 100 rule’; what is the dose of insulin required to correct BSLs by 1mmol?

Answer 6

Total daily insulin / 100

Therefore TDI/100 x the change in BSL req.

Question 7

What do you use to resuscitate a pt with sever hypoglycaemia? (IV vs no IV access)

Answer 7

If IV access: 50mL 50% Dextrose (syrup-like!)

If NO IV access: 1mg Glucagon IM