DKA

Question 1

RF/triggers

Answer 1

Infection (sepsis), MI, surgery, non compliance

Question 2

Symptoms and signs

Answer 2

Symptoms: Nausea and Vomit, abdo pain, fruity/ketotic breath, confusion, headache

Signs: BM’s hyperglycaemic, Kussmaul breathing, dehydrated.

Question 3

Investigations

Answer 3

Bloods: ABG, urine dip

FBC, UandE, CRP, glucose, ketones. HOURLY ketones and glucose.

Question 4

Management

Answer 4

50 units insulin (refer hospital guidelines)
Fluids, (K+ can be low due to insulin)
If infective cause, MSU and CXR.
Consider catheter and NG feeds for fluid balance.

Question 5

Complications

Answer 5

Metabolic acidosis
Cerebral oedema
Hypokalaemia
DVT then PE.