Diabetic Ketoacidosis Management Flashcards
7 cards from real Internal Medicine Exam practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Diabetic Ketoacidosis Management flashcards as text
A patient with DKA has a serum potassium of 3.2 mEq/L on arrival. What is the correct next step before starting insulin?
Answer: Replace potassium to ≥3.5 mEq/L before starting insulin
Insulin drives potassium intracellularly, so potassium must be ≥3.5 mEq/L before insulin is started to prevent life-threatening hypokalemia.
Which of the following best describes the anion gap in uncomplicated DKA?
Answer: Elevated anion gap metabolic acidosis
DKA causes elevated anion gap metabolic acidosis due to accumulation of beta-hydroxybutyrate and acetoacetate.
A 28-year-old with type 1 diabetes presents with DKA. Blood glucose is 520 mg/dL. After 1 hour of insulin infusion, glucose drops to 250 mg/dL. What should be added to IV fluids?
Answer: Add dextrose to IV fluids and continue insulin
Dextrose is added to IV fluids when glucose reaches 200–250 mg/dL to allow continued insulin infusion and ketone clearance.
Which laboratory finding is most consistent with resolution of DKA and readiness to transition to subcutaneous insulin?
Answer: Serum bicarbonate ≥ 18 mEq/L and anion gap ≤ 12
Resolution criteria include anion gap ≤12 mEq/L, serum bicarbonate ≥18 mEq/L, and pH >7.3 — all three should be met before transitioning.
A patient is transitioning from insulin drip to subcutaneous insulin after DKA resolution. How long should the insulin drip overlap with the first subcutaneous dose?
Answer: 1–2 hour overlap
The insulin drip should overlap with subcutaneous insulin for 1–2 hours to prevent rebound hyperglycemia and ketoacidosis.
A patient with DKA has a measured serum sodium of 128 mEq/L. Blood glucose is 600 mg/dL. What is the corrected sodium?
Answer: 136 mEq/L
Corrected sodium = measured Na + 1.6 × [(glucose − 100)/100]; here: 128 + 1.6 × 5 = 136 mEq/L.
Which precipitating factor accounts for the majority of DKA cases in known diabetics?
Answer: Medication non-compliance
Insulin omission or non-compliance with insulin therapy is the most common precipitant of DKA in patients with known diabetes.