DKA 1

Question 1

Diabetic Ketoacidosis: metabolic ? in which ? is associated with metabolic ? due to greatly raised ? levels.
It is associated with ?, but can rarely occur in ?.

Answer 1

emergency
hypergly
acidosis
ketone
t1
t2

Question 2

Accumulation of ? bodies causes a metabolic ?.
o They can be detected on the ? and in the ?.
Respiratory compensation leads to ?.
Acidosis causes ?, and further ?/? loss.

Answer 2

ketone
acidosis
breath
urine
hyperventilation
vomiting
fluid/E-

Question 3

? perfusion falls, leading to impaired excretion of the ? H+ and
ketones.
o There is increased excretion of ? and ?.
o Despite a significant total body deficit of K+ ? serum K+ is typically normal, or even elevated (?-hyperkalaemia).
o This is due to ? ? of K+ in response to acidosis & insulin deprivation
o Serum K+ levels will then usually ? during treatment as the exogenous ? drives K+ into cells.
o If serum K+ is not monitored and replaced as needed, life-threatening
? may develop.

Answer 3

renal
raised
na
k
initial
pseudo
extracellular migration
fall
insulin
hypokalaemia

Question 4

Common reasons for DKA development;

Previously ? ?.
Interruption of ? therapy.
The stress of intercurrent ?/?.

Answer 4

unDx DM
insulin
illness/surgery

Question 5

Clinical presentation;
Prostration. (extreme ?)
? respiration: air ?.
? & ?.
? pain.
Confusion/ ?.

Answer 5

weakness
kussmaul
hunger
N+V
abdo
stupor

Question 6

On examination there may be evidence of marked ?, with the ? of ketones on the ?. There is often a history of marked ? .

Answer 6

dehydration
smell
breath
polyuria

Question 7

Diagnosis (? ? required);

1. Blood glucose >?mmol/L.
   - ——a. or previously known diabetes.
2. Capillary ketones >?mmol/L.
   - ——a. or Ketones >?+ in urine.
3. Venous pH .
   - ——a. or venous ? <15 mmol/L.

Answer 7

all 3
11
3
2
7.35
bicarb

Question 8

Essential investigations;

?, ?, blood ?.
? Blood ?: ? puncture not generally required.
o Metabolic ? with a ? anion gap.
???/ ? XR /?/ ? test based on clinical suspicion.
o N.b. raised ? ? ? is common, as is raised ?

Answer 8

u+E
creatinine
glucose
VBG
arterial
acidosis
raised
ECG
Chest
Cultures
pregnancy
WCC
amylase

Question 9

Severity is determined by ? rather than blood glucose;
Mild: > ?.
Moderate: ?-?
Severe:

Answer 9

7. 3
8. 1-7.3
9. 1