diabetic ketoacidosis Flashcards

1
Q

what can DKA be precipiated by?

A
  • new diagnosis of T1DM
  • not taking insulin
  • intercurrent stress (e.g. pneumonia)
  • fasting and not taking enough insulin
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2
Q

what are the 4 main causes of ketoacidosis?

A
  • fasting
  • insulin deficiency
  • stress hormones
  • dehydration
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3
Q

what is the metabolic acidosis caused by? what does it lead to?

A
  • metabolic acidosis is caused by reduction in bicarbonate production and inc. H+ buffering
  • results in Kussmahl respiration to blow off CO2 to reduce acidosis
  • water lost in urine and so is Na+
  • this means K+ is lost in urine
  • although acidosis shows a high K+, total body K+ is low
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4
Q

what are the clinical features of DKA?

A
  • polyuria and polydipsia due to diuresis
  • dehydration
  • hyperventilation
  • abdo pain and vomiting
  • coma
  • gycosuria and ketonuria
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5
Q

what investigations should be carried out?

A
  • capillary and plasma glucose
  • creatinine, K+, Na+
  • FBC
  • arterial blood gas
  • amylase
  • ECG, CXR, septic screen
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6
Q

what is the treatment?

A
  • fluid (normal saline)
  • insulin (give dependent on blood glucose levels)
  • potassium
  • bicarbonate
  • cardiac monitor, catheterise, antibiotics, heparin
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