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Pco2 In Dka

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This video relates abdominal pain according to different abdominal regions and states the most important differential diagnosis of each pain position.

Exam Shows Diffuse Abdominal Tenderness With Guarding.

A 14 y/o female is brought to the emergency department by her mother after being found unresponsive at home. She had been ill the day before with nausea and vomiting, but was not running a fever. Her parents had kept her home from school that day. When her mother came home at lunchtime to check on her, she was very lethargic and not responding coherently. By the time she arrived at the hospital, she had to be brought in to the ED on a gurney. Initial evaluation showed O2 sat 100% on room air, pulse 126, respirations 30, BP 92/68, temperature 101.2 F. She appears pale, mucous membranes are dry and she only responds to painful stimuli. Exam shows diffuse abdominal tenderness with guarding. Differential diagnosis? What initial treatment would you suggest? What labs would you order? Any xrays or additional studies? CBC WBC 23,500 Hgb 14.2 g/dL Hct 45% Platelets 425,000 BMP Sodium 126 Potassium 5.2 Chloride 87 CO2 <5 BUN 32 Creatinine 1.5 Glucose 1,376 Arterial Blood Gases pH 7.19 Po2 100 mm Hg HCO3 7.5 mmo/L Pco2 20 mm Hg Sao2 98% (room air) Urine Specific gravity 1.015 Ketones 4+ Leukocytes few Glucose 4+ Nitrates 0 RBCs many Diabetic ketoacidosis (DKA) is an acute metabolic complicat Continue reading >>

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  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!

  4. -> Continue reading
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Alternative Management Of Diabetic Ketoacidosis In A Brazilian Pediatric Emergency Department

Go to: DKA is a severe metabolic derangement characterized by dehydration, loss of electrolytes, hyperglycemia, hyperketonemia, acidosis and progressive loss of consciousness that results from severe insulin deficiency combined with the effects of increased levels of counterregulatory hormones (catecholamines, glucagon, cortisol, growth hormone). The biochemical criteria for diagnosis are: blood glucose > 200 mg/dl, venous pH <7.3 or bicarbonate <15 mEq/L, ketonemia >3 mmol/L and presence of ketonuria. A patient with DKA must be managed in an emergency ward by an experienced staff or in an intensive care unit (ICU), in order to provide an intensive monitoring of the vital and neurological signs, and of the patient's clinical and biochemical response to treatment. DKA treatment guidelines include: restoration of circulating volume and electrolyte replacement; correction of insulin deficiency aiming at the resolution of metabolic acidosis and ketosis; reduction of risk of cerebral edema; avoidance of other complications of therapy (hypoglycemia, hypokalemia, hyperkalemia, hyperchloremic acidosis); identification and treatment of precipitating events. In Brazil, there are few pediatri 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!

  4. -> Continue reading
read more
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10 arterial blood gas problems worked using the tic-tac-toe method.

Abg (arterial Blood Gas)

Arterial Blood Gas analysis typically measures: And may include: These measurements are often used to evaluate oxygenation of the tissues and pulmonary function. pH is a measurement of the acidity of the blood, reflecting the number of hydrogen ions present. Lower numbers mean more acidity; higher number mean more alkalinity. pH is Elevated (more alkaline, higher pH) with: Hyperventilation Anxiety, pain Anemia Shock Some degrees of Pulmonary disease Some degrees of Congestive heart failure Myocardial infarction Hypokalemia (decreased potassium) Gastric suctioning or vomiting Antacid administration Aspirin intoxication pH is Decreased (more acid, lower pH) with: Strenuous physical exercise Obesity Starvation Diarrhea Ventilatory failure More severe degrees of Pulmonary Disease More severe degrees of Congestive Heart Failure Pulmonary edema Cardiac arrest Renal failure Lactic acidosis Ketoacidosis in diabetes pCO2 (Partial Pressure of Carbon Dioxide) reflects the the amount of carbon dioxide gas dissolved in the blood. Indirectly, the pCO2 reflects the exchange of this gas through the lungs to the outside air. Two factors each have a significant impact on the pCO2. The first is how r 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!

  4. -> Continue reading
read more

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