DKA Flashcards

1
Q

define DKA?

A

• Diabetic ketoacidosis is a state of high ketones due to uncontrolled lipolysis which results excess free fatty acids and therefore ketone bodies. Accompanied by very high glucose levels

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2
Q

who does DKA occur in?

A

• It is common in T1DM

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3
Q

what are the causes of DKA?

A

o Infection
o Missed insulin doses
o Myocardial infarction

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4
Q

what are the presenting symptoms of DKA?

A
o	Abdominal pain 
o	Vomiting
o	Polyuria, polydipsia and dehydration 
o	Kussmaul respiration 
o	Acetone smelling breath
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5
Q

what are the key investigations and results of a DKA?

A

o glucose > 11 mmol/l or known diabetes mellitus
o ABG: pH < 7.3
o bicarbonate < 15 mmol/l
o ketones > 3 mmol/l or urine ketones ++ on dipstick

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6
Q

how is a DKA managed?

A

o 1. Fluid replacement – normal saline
o 2. Insulin – IV infusion at a fixed rate with long acting insulin (no short acting)
o 3. Correction of electrolyte disturbance – insulin causes potassium to drop

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7
Q

when can management of a DKA be stopped?

A

o PH> 7.3
o Blood ketones <0.6mmol/L
o Bicarbonate >15mmol/L

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8
Q

what are the complications of a DKA?

A

o Gastric stasis
o Thromboembolism
o Arrhythmias secondary due to hyperkalaemia
o Iatrogenic due to incorrect fluid therapy
o Cerebral oedema (in kids especially!) – causes seizures
o ARDS
o AKI

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