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Are you studying for the step exams or the shelf? Want to see many examples of the same condition in one place so you don't have to wait days to have concepts reinforced? If this sounds like you check out my posts! This post is on Diabetic Ketoacidosis (DKA).
DKA is another very common exam topic. Like other test topics, it isn’t rocket science, however can have a wide variety of presentations. Lets try and cover some of the more universal aspects of the condition:
1.) Symptoms: confusion/disorientation, nausea/vomiting, fatigue/weakness, and abdominal pain are all possible ways patients can present. It varies question to question.
2.) Patient history: patients my have a history of type 1 diabetes or clues that they are diabetic (history of frequent urination + thirst).
3.) Physical exam: rapid, deep breathing (i.e. Kussmaul respirations) is classically present. Sometimes all that is here is an increased respiration rate but it is almost always present. Generalized abdominal pain is also classic for DKA (but not always reported in questions)
4.) Labs: there are so many possibilities. The basics though will be elevated serum glucose, acidemia, and ketones in the urine/blood. Other findings like low bicarb, elevated serum potassium, and low arterial CO2 (lost by rapid breathing) are also often seen.
5.) Fruity odor on breath: this is one of those key phrases that is not always stated because it just gives away the diagnosis. I don’t think any other condition will give you fruity odor on your breath (attributed to the ketones) so this essentially pathognomonic (on standardized exams).
Take a look at the examples below to see the range of how this condition shows up on exams!
I can't post links just yet (just started on SDN) but go to the website stepwards and search Diabetic Ketoacidosis (DKA) to find the archive of questions that this post corresponds to.
DKA is another very common exam topic. Like other test topics, it isn’t rocket science, however can have a wide variety of presentations. Lets try and cover some of the more universal aspects of the condition:
1.) Symptoms: confusion/disorientation, nausea/vomiting, fatigue/weakness, and abdominal pain are all possible ways patients can present. It varies question to question.
2.) Patient history: patients my have a history of type 1 diabetes or clues that they are diabetic (history of frequent urination + thirst).
3.) Physical exam: rapid, deep breathing (i.e. Kussmaul respirations) is classically present. Sometimes all that is here is an increased respiration rate but it is almost always present. Generalized abdominal pain is also classic for DKA (but not always reported in questions)
4.) Labs: there are so many possibilities. The basics though will be elevated serum glucose, acidemia, and ketones in the urine/blood. Other findings like low bicarb, elevated serum potassium, and low arterial CO2 (lost by rapid breathing) are also often seen.
5.) Fruity odor on breath: this is one of those key phrases that is not always stated because it just gives away the diagnosis. I don’t think any other condition will give you fruity odor on your breath (attributed to the ketones) so this essentially pathognomonic (on standardized exams).
Take a look at the examples below to see the range of how this condition shows up on exams!
I can't post links just yet (just started on SDN) but go to the website stepwards and search Diabetic Ketoacidosis (DKA) to find the archive of questions that this post corresponds to.