Diabetic Ketoacidosis – Post Test

What does insulin induce?

In DKA which of the following has to be present for the diagnosis to be made?

In a patient with DKA which of the following is true?

Which of the following is the most common presenting complaint in a patient with DKA?

Which of the following drugs will NOT precipitate DKA?

In a patient who has been diagnosed with DKA, the following blood gas is done:

pH 7.1

pCO2 2.4 kPa

Bicarbonate 14mmol/L

Na 138mmol/L

K 3.1mmol/L

Ionised Calcium 1.2mmol/L

Glucose 26.4mmol/L

The patient is already on oxygen and has 1L of normal saline prescribed.

What is the most appropriate next step in the management of this patient?

In DKA what is the prime cause for the change in pH?

A 36-year-old male with type I diabetes, presents with a productive cough, green sputum and feeling generally unwell. Examination reveals a temperature of 38 degrees Celsius, a respiratory rate of 26 breaths/minute, pulse of 110 beats/minute. CXR demonstrates a left lower lobe pneumonia and the blood sugar is 28mmol/L.

ABG is done on air

pH 7.0,

pCO2 2.8 kPa,

pO2 11.2 kPa

Base excess 10

Bicarbonate 14mmol/L

Na 134mmol/L

K 4.2mmol/L.

He is treated initially with IV Augmentin 1.2g, IV insulin on a sliding scale and 2L of normal saline over 2 hours.

You are asked to review him 2 hours after treatment was initiated as he has twitching movements on the right side of the body and a GCS of 9/15.

What is the most likely diagnosis for his deterioration?

A patient with DKA is being treated with 0.1 u/kg/hr IV insulin infusion.

The blood sugar however is not decreasing.

What would be the next most appropriate step to take?