DKA

Question 1

Precipitating factors of DKA

Answer 1

Infection, missed insulin doses, myocardial infarction

Question 2

Features of DKA

Answer 2

Abdominal pain, polyuria, polydipsia, dehydration, Kussmaul respiration, acetone-smelling breath

Question 3

Diagnostic criteria for DKA

Answer 3

Glucose >11
pH<7.3
Bicarbonate <15
Ketones >3 or urine ketones ++ on dipstick

Question 4

Main prinicples of management of DKA

Answer 4

Fluid replacement, insulin, correction of electrolyte disturbance, long acting insulin continued, short acting stopped

Question 5

Treatment of DKA when blood glucose has fallen to <14 mmol/l

Answer 5

Infusion of 10% dextrose started at 125mls/hr in addition to the 0.9% sodium chloride regime

Question 6

Complications of DKA or the treatment of DKA

Answer 6

Gastric stasis, thromboembolism, arrythmias, cerebral oedema, hypokalaemia, hypoglycaemia, hyperkalaemia, acute resp distress, AKI