Week 2 (2)

Question 1

Give four complications of DKA?

Answer 1

1. Cardiac arrest - due to low potassium
2. ARDS
3. Cerebral oedema
4. Gas in stomach

Question 2

Explain replacing losses in management of DKA?

Answer 2

Fluid - initially with 0.9% sodium chloride (if glucose falls to 15 switch to dextrose)
Insulin - IV
Potassium

Question 3

What should be additionally prescribed in DKA to prevent a risk?

Answer 3

LMWH

Question 4

What does blood ketone monitoring measure?

Answer 4

Beta-hydroxybutyrate

Question 5

What does urine ketone testing measure?

Answer 5

Acetoacetate

Question 6

Name two medications that can cause the risk of HHS?

Answer 6

Glucocorticoids and thiazides

Question 7

Which has a higher glucose - DKA or HHS?

Answer 7

HHS

Question 8

What is the osmolality equation?

Answer 8

2 x [Na+K] + urea + glucose

Question 9

Is HHS more common in type I or II diabetes?

Answer 9

Type II

Question 10

What can fizzy drinks cause - DKA or HSS?

Answer 10

HSS

Question 11

What is the normal lactate range?

Answer 11

0.6 to 1.2 mmol/l

Question 12

What type of lactic acidosis is associated with tissue hypoxaemia?

Answer 12

Type A

Question 13

What type of lactic acidosis does infarcted tissue, cardiogenic shockl, hypovolaemic shock, sepsis and haemorrhage cause?

Answer 13

Type A

Question 14

What type of Lactic acidosis might occur in liver disease, leukaemic states and is associated with diabetes?

Answer 14

Type B

Question 15

Give three clinical findings of lactic acidosis?

Answer 15

1. Hyperventilation
2. Mental confusion
3. Stupor

Question 16

What two things are raised in lactic acidosis?

Answer 16

1. Anion gap

2. Phosphate

Question 17

What is the treatment for alcohol-induced ketoacidosis?

Answer 17

1. Pabrinex - high dose vitamins

2. IV fluids particularly dextrose