DKA IN PREGNANCY

Question 1

What is the condition described in the context of pregnancy and COVID-19?

Answer 1

Diabetic ketoacidosis (DKA) with severe COVID-19

This condition is compounded by pregnancy-related biochemical changes.

Question 2

What is the blood glucose threshold for euglycemic DKA?

Answer 2

Below 250 mg/dL (<13.9 mmol/L)

This indicates a specific type of DKA that occurs despite normal or low blood glucose levels.

Question 3

What is the normal anion gap for pregnancy?

Answer 3

~8.5 mEq/L

The anion gap may be normal but elevated for pregnancy.

Question 4

What biochemical markers indicate DKA in pregnancy?

Answer 4

Elevated 3-hydroxybutyrate and bicarbonate concentration of 18 mEq/L or lower

These markers are critical for diagnosing DKA.

Question 5

Why may bicarbonate levels be lower in pregnancy?

Answer 5

Due to compensation for respiratory alkalosis

This compensation could lead to an overestimation of DKA severity.

Question 6

What is an incorrect approach to managing DKA?

Answer 6

Observation

DKA requires active treatment rather than simply monitoring.

Question 7

What is the first step in treating DKA?

Answer 7

Intravenous Fluids

This is followed by potassium repletion and insulin infusion.

Question 8

Under what condition should bicarbonate infusion be administered?

Answer 8

If blood pH is very low (<6.9)

This is a specific treatment consideration in severe cases.

Question 9

What type of fluids is sufficient for volume repletion in DKA?

Answer 9

Normal saline

Lactated Ringer’s can be used later but is not prioritized over insulin therapy.