Author: Lian Dimaro, Faisal Faruqi / Editor: Steve Corry-Bass / Codes: MHC1, SLO1 / Published: 12/11/2020
A 46-year-old man presents with anxiety and feeling overwhelmed. He denies any recent illness and has been drinking alcohol after a prolonged period of abstinence.
He gives a history of anxiety and depression including a previous insulin overdose. He also has a background of chronic pancreatitis, alcohol excess and type 2 diabetes (on insulin).
His observations show tachypnoea (RR24), hypotension (BP 98/64) and tachycardia (HR117). He is otherwise alert, apyrexial and his chest is clear. (Saturations= 97% on air). Abdomen is soft non-tender.
Venous blood gas reveals an elevated anion gap metabolic acidosis – pH 7.27(7.35- 7.45) ), lacticema 2.7mmol/L (0-2), with hypoglycaemia – glucose 2.3mmmol/L (4- 11). Urinary ketones= Nil.
Laboratory bloods show an alcohol level of 134mg/dL. ( Normal <100) , mild neutrophilia, CRP <5, and normal LFTs. He is diagnosed and treated as hypoglycaemia and alcoholic ketoacidosis, with glucose, intravenous fluids and pabrinex. The anxiety resolved as his blood glucose and acidaemia improved.
Module Content
Paediatric Diabetic Ketoacidosis
This session will explore the management of diabetic ketoacidosis in young people with relevance to the published evidence and national guidelines.
Paediatric Diabetic Ketoacidosis
This session will explore the management of diabetic ketoacidosis in young people with relevance to the published evidence and national guidelines
Alcoholic Liver Disease
Alcohol abuse is undoubtedly a huge social problem in the UK. It is responsible for many unnecessary attendances to Emergency departments (ED) and is an enormous burden on the NHS, which must treat the complications of alcohol abuse
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