emergency med

Question 1

why is there hypokalaemia in DKA?

Answer 1

on pres might be normal or high because of extracellular leakage due to insulin deficiency and acidosis. hypokalaemia results because of osmotic diuresis

Question 2

what is alcoholic ketoacidosis?

Answer 2

• non-diabetic euglycaemic form of ketoacidosis (normal glucose levels)
• occurs in people who regularly drink large amounts of alcohol
• often alcoholics dont eat regularly and may vomit food that they do eat, leading to eps of starvation
• once the person becomes malnurished, after an alcohol binge the body can start to break down body fat, producing ketones. hence the pt dvelops ketoacidosis

typically presents with patter of:

• metabolic acidosis
• elevated anion gap
• elevated serum ketone levels
• normal or low gluscose concentration

Mx = infusion of saline and thiamine. thismaine is required to avoid wernicke encephalopathy or korsakoff psychosis