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Medicine

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Endocrine

Question
2 out of 14
 

Presence of infection in a case of DKA is best indicated by? (AIIMS May 2011)



A Very high blood sugar
B Presence of Fever

C Leukocytosis
D Ketonuria

Ans. B

Presence of Fever

DIABETIC KETOACIDOSIS

Clinical features –

Symptoms – Nausea, vomiting, Abdominal pain Q Altered mental function. Shortness of breath

Signs –

1). Tachycardia

2). Dry mucous membrane

3). Dehydration

4). Hypotension

5). Kussmaul respiration Q

6). Tachypnea

7). Abdominal tenderness

8). Fever. May be there

9). Fruity odour of the breath

Extra Edge: Medical diseases having severe pain abdomen (Acute abdomen)

1). Acute intermittent Porphyria

2). Addisonian crises

3). Sickle cell anemia

4). Renal papillary necroses

5). Basal pneumonia

6). Inferior wall MI

7). DKA

8). Abdominal migraine

9). Abdominal epilepsy

10). Tabetic crises

FIGURE - Pathogenesis of diabetic ketoacidosis.

Investigations

1). Hyperglycemia – Blood sugar 400 – 600 mg%

2). TLC – Leucocytosis. It is a feature of DKA. It does not indicate infection. Presence of fever indicate infection

3). Na+ - Pseudohyponatremia

4). K+ - increase (shifting of K+ from intracellular to extracellular compartment due to decrease Insulin)

5). Blood urea – increase (due to intravascular fluid depletion)

6). S. Osmolality 300 – 320mosm/Kg

7). Plasma ketones – Positive

8). Metabolic acidosis - Low HCO-3 with increase anion gap.

9). Hypertriglyceridemia – Hyperlipoproteinemia

10). Hyperamylasemia

Endocrine Flashcard List

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