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Pco2 In Dka

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Diabetic Ketoacidosis

About Diabetic ketoacidosis must be managed with a defined well documented and communicated plan It is seen in new presentations and Type 1 diabetics with intercurrent illness and poor control Patients need education on not to stop insulin when unwell and to seek medical help There is a severe deficit of Fluid, Insulin and Potassium Aetiology Glucose and K+ usually enter cells through the actions of Insulin In DKA the Insulin deficit leads to cell starvation and a switch to burning fatty acids The beta-oxidation of fats creates acid byproducts which lower the pH At the same time there is a profound osmotic diuresis due to the severe hyperglycaemia Vomiting can compound the fluid losses Clinical Recent thirst, polyuria and polydipsia, vomiting and breathlessness Severe hyperventilating Kussmaul's respiration to blow off CO2 Smell of acetone "nail varnish" on the breath (not all of us can smell it) Profound dehydration and volume loss from polyuria due to glycosuria Sunken eyes, reduced skin turgor, hypotensive, tachycardia, oliguric Possibly sepsis - chest and urine or elsewhere Investigations Ketonuria 3+ and glycosuria and Raised [glucose] There is a low bicarbonate < 15 mmols/l F Continue reading >>

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Popular Questions

  1. soxman

    So when a pt comes in with DKA I know that the pH is low due to the acidic ketone bodies and HCO3- gets low in an attempt to buffer and I can understand how initially the PCO2 is low. BUT for most questions I see, the stem usually refers to stating that the patient is lethargic ...so in that case wont the PCO2 be high due to hypoventilation?

  2. Convalaria

    lethargic is the state of consciousness. patient still can hyperventilate, namely DKA coma is characterized by Kussmaul breathing pattern: rapid and deep

  3. soxman

    Convalaria said: ↑
    lethargic is the state of consciousness. patient still can hyperventilate, namely DKA coma is characterized by Kussmaul breathing pattern: rapid and deep makes sense! thanks!

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