DKA

Question 1

what is it

Answer 1

a medical emergency that is characterised by hyperglycaemia
acidosis
ketonaemia

Question 2

what are the specific values to diagnose DKA

Answer 2

ketonaemia = >3mmol/L
blood glucose = >11mmol/L
bicarbonate = <15mmol/L or a venous pH less than 7.3

Question 3

what causes it

Answer 3

infection
dehydration
fasting
or first presentation of T1DM

*fever is not a part of DKA presentation ie if a patient with high fever is having DKA then underlying cause of infection has triggered it

Question 4

what causes it

Answer 4

infection
dehydration
fasting
or first presentation of T1DM

*fever is not a part of DKA presentation ie if a patient with high fever is having DKA then underlying cause of infection has triggered it

Question 5

how does it present

Answer 5

fruity breath (acetone)
vomitting
dehydration
abdominal pain
hyperventilation - Kussmaul
hypovolaemic shock
drowsiness
coma

Question 5

how does it present

Answer 5

fruity breath (acetone)
vomitting
dehydration
abdominal pain
hyperventilation - Kussmaul
hypovolaemic shock
drowsiness
coma

Question 6

management of dka patient if they are alert, and seem able to tolerate oral intake without vomiting

Answer 6

encourage oral intake and give subcutaneous insulin injection

Question 7

management of dka patient if they are confused, vomiting or significantly dehydrated

Answer 7

give IV fluids (initial bolus of 10mls/kg 0.9% NaCl) and insulin infusion at 0.1units/kg/hour after starting IV fluids

evidence of shock = initial bolus should be 20mls/kg

Question 8

management if dka patient is shocked or comatose

Answer 8

ABCDE approach

Question 9

what is a rare complication of dka

Answer 9

hours after fluids and insulin infusion has been administered

symptoms of cerebral oedema can set in ie headache, deterioration in her neurological status and bradycardia