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Endocrine Emergencies {Diabetic Ketoacidosis (DKA)} - Coggle…
Endocrine Emergencies
{Diabetic Ketoacidosis (DKA)}
Definition:
Acute life-threatening hyperglycemic emergency caused by insulin deficiency.
Pathophysiology
1-Hyperglycemia due to
-Increased gluconeogenesis and glycogenolysis.
2-Ketogenesis:
-Breakdown of fats producing ketones.
3-Acidosis:
-Ketones lower blood pH.
4-Dehydration due to osmotic diuresis.
Causes & Risk Factors
Infection (major precipitant).
Stress (surgery, trauma).
Poor insulin compliance.
Medications (steroids, diuretics).
Substance abuse (alcohol, cocaine).
Clinical Presentation
1-DKA Triad:
Hyperglycemia, Acidemia, Ketonaemia.
2-Other Signs:
-Kussmaul breathing, acetone breath odor.
-Tachycardia, hypotension (due to dehydration).
-Altered mental status (coma in severe cases).
Diagnosis
Blood glucose > 250 mg/dL.
pH ≤ 7.3, HCO3 ≤ 15 mmol/L.
Anion gap > 12 mmol/L.
Serum/urine ketones positive.
Management of DKA
1-Initial Stabilization:
-Airway and breathing assessment.
-Continuous cardiac monitoring.
2-Fluid Replacement:
-Start with normal saline.
-Correct 50% of fluid loss in 4 hours.
3-Insulin Therapy:
-IV insulin infusion to reduce glucose and ketosis.
4-Electrolyte Correction:
Potassium replacement as needed.
5-Monitoring:
-Frequent glucose and electrolyte checks.
-Serial ABGs to monitor pH and bicarbonate levels.
Complications to Monitor
Cerebral edema.
Hypoglycemia from insulin therapy.
Hypokalemia.