DKA Flashcards

1
Q

Define DKA

A

Increased lipolysis and increased gluconeogenesis eventually results in excess ketone levels leading to ketoacidosis.

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2
Q

what is the pathophysiology behind DKA

A

-Due to low insulin, there is unrestrained lipolysis and gluconeogenesis.
-Excess glucose is converted into ketones too if they are not used.

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3
Q

What does lipolysis result in?

A

Lipolysis results in fats broken down into fatty acids which are broken down into ketones.

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4
Q

what ph are ketones?

A

acidic

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5
Q

what are key features of DKA

A
  • dehydration
  • ketoacidosis
  • potassium imbalance.
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6
Q

what are the risk factors for DKA?

A
  • Undiagnosed T1DM
  • Infection/Illness
  • Being under 20 years old
    -Poor Insulin compliance
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7
Q

What are the differential diagnosis’ for DKA?

A

-HHS
- Lactic Acidosis (Identical Presentation, but normal ketones and glucose)
- Starved Ketosi

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8
Q

what are complications of DKA

A
  • Coma
  • Cerebral oedema
  • Thromboembolism
  • Aspiration pneumonia
  • Death
  • Dehydration
  • MI
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9
Q

What are signs of DKA?

A
  • Fruity “Pear Drop” Breath
  • Kussmaul breathing (fast, deep breaths
  • Reduced Tissue Turgor
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10
Q

What are the symptoms for DKA?

A
  • Polyuria
  • Polydipsia
  • Hyperglycaemia
  • Potassium imbalance
  • Weight loss
  • Nausea and vomiting
  • Reduced consciousness
  • Acidosis
  • Hypotension
  • Dehydration
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11
Q

how is DKA diagnosed?

A

Requires all 3 of:
- Hyperglycaemia (blood glucose over 11mmol/l)
- Ketosis (blood ketones over 3mmol/l)
- Acidosis (pH under 7.3)

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12
Q

what is the treatment for DKA?

A

ABCDE should be followed first.
THEN:
F – Fluids – IV 0.9% Saline
I – Insulin at 0.1 units/kg/hour
G – Glucose – Add glucose IV if <14mmol/l
P – Potassium – Add Potassium to IV fluids
I – Infection – Treat underlying infection
C – Chart fluid balance
K – Ketones – Monitor ketones, pH and Bicarbonate levels

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13
Q

What are some complications of the treatment for DKA?

A

hypoglycaemia, hypokalaemia, cerebral oedema and pulmonary oedema.

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14
Q

Compare DKA and HHsS

A

DKA-
T1DM-
-Patients younger and leaner
-Ketoacidosis
- Develops over hours to a day
-HHS
- T2DM
- No ketoacidosis
- Significantly higher mortality rate
- develops over a longer time
- days to a week

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