DKA

Question 1

When do you switch from NS to D5-1/2NS?

Answer 1

at 200 mg/dl glucose level

Question 2

What causes DKA?

Answer 2

Insulin deficiency

Question 3

Symptoms of DKA (5)?

Answer 3

1- Nausea/vomit
2- Abdominal pain
3- polyuria
4- polydipsia
5- Kussmaul Atmung
6- Altered mental status

Question 4

Lab results DKA?

Answer 4

1-  Hyperglycemia (>250mg/dL)
2- Hypokalemia
3- Ketonemia
4- Acidemia (pH<7.3)
5- Serum Bicarbonate <15meq/L
6- Base deficit (>4)

Question 5

Pillars of DKA management?

Answer 5

Fluids, 1000cc/hr for 1st few hours
Insulin IV drip
K+ (20meq/hr if <3,3 meq/L)

Question 6

DKA in pregnancy rate?

Answer 6

< or equal to 3% of diabetic women

Question 7

How do you monitor progress?

Answer 7

regular ABGs (measuring acidemia)
K+ levels
Blood glucose

Question 8

How quickly should blood glucose levels be decreasing during Tx?

Answer 8

50-75mg/dL/hr

Question 9

At what rate should insulin be given in DKA?

Answer 9

0,1U/Kg bolus over 5-10min followed by 0,1U/Kg/hr

Question 10

Common risk factors for DKA?

Answer 10

New onset diabetes
Infections, such as influenza and urinary tract infection; Poor compliance;
Insulin pump failure; and
Treatment with β-mimetic tocolytic medications
Antenatal Corticosteroids