Week 4 - Severe dehydration in a young woman Flashcards
What is her Glasgow coma score?
Her Glasgow coma score is 10 (E3, V2, M5).
E3 - Eyes open to speech
V2 - Incomprehensible sounds
M5 - Moves to localised pain.
Provide a list of differential diagnoses.
What should be done immediately when you suspect DKA? (6)
A finger-prick blood glucose measurement has been obtained using a bedside glucose meter an
reads ‘high’. A urinary catheter drains 50mL urine which, when tested with a strip, registers Ketone as ++. After initial resuscitation, results of the preliminary blood tests come back as follows:
- What are the abnormalities? How do they clarify your differential diagnosis?
- Explain the pathophysiology of low potassium in DKA?
What is your acute management plan for a patient with DKA?
- 7 Principle steps in her management?
Diabetic ketoacidosis is an acute medical emergency, requiring rapid diagnosis and treatment. These patients are critically ill and need specialized care and close monitoring. The patient’s vital signs must be observed regularly, and recorded along with fluid input and output and bedside blood glucose monitoring. If the patient’s potassium concentrations are significantly abnormal cardiac monitoring may be needed. Ketoacidosis may induce gastroparesis and the patient should be kept fasted to minimize the risk from gastric aspiration.
Fluid and Sodium Replacement in DKA?
Correction of Acidosis and
Hyperglycaemia with Insulin in DKA?
Potassium Replacement in DKA?
Diagnosis and Treatment of
Precipitating Events in DKA?
Prevention of the Complications of DKA?
How wil you change her insulin therapy now?
Describe your ongoing management plan for this patient while she is in
hospital and prior to discharge.
Describe your ongoing management plan for this patient as an outpatient.
Diagnostic thresholds for diabetes:
- glycated haemoglobin (HbA1c)?
- venous BGC?
- oral glucose tolerance test?
What are some of the Limitations of HbA1c tests? When is it not accurate?
Discuss the different types of Insulin treatment for children and adolescents with type 1 diabetes?
Discuss when a Multiple daily injection (basal–bolus) insulin regimen is appropriate for TIDM in children and adolescents?
Discuss when a Multiple daily injection (basal–bolus) insulin regimen is appropriate for TIDM in children and adolescents?
Discuss when a Continuous subcutaneous insulin infusion
regimen is appropriate for TIDM in children and adolescents?
What is the AUSDRISK tool?
Frequency of screening for type 2 diabetes in adults
Screening for diabetes should be repeated every 12 months for adults identified as being at high risk of developing type 2 diabetes, and for those who have values of diagnostic testing in the range for prediabetes. ATSI peoples can also be screened annually, without cost to the individual, using the Medicare Health Assessment for Aboriginal and Torres Strait Islander peoples.
Which children and adolescents should be screened for type 2 diabetes? Frequency?
