OSCE: Diabetic Ketoacidosis (DKA)
Journal Title: Journal Of Pediatric Critical Care - Year 2019, Vol 6, Issue 1
Abstract
11year female child, a known case of diabetes mellitus type 1 for the last one year and on insulin therapy brought with history of high-grade fever, burning micturition and fast breathing since 3 days. She was irritable for the last one day. No defi nite history of polyuria. On examination she was irritable, pale looking, GCS 11/15, respiratory rate 24/min, SPO2 92% in room air, HR 152/min, BP 82/50, abdomen soft. CBC 10.3/22000/76,20,2,2, Platelet 1.3cmm, CRP positive, blood sugar 524 mg/dL, serum sodium 147 mEq/L, potassium 3.4 and repeat after 6 hours >6.0 mEq/L, chloride 118 mEq/L, blood urea 78mg/ dL, creatinine 1.6 raised to 2.3 mg/dL, calcium 11.2 mg/dL, phosphate 3.3 mg/dL, magnesium 2.2, serum bilirubin 0.5mg/dL, SGOT/PT 42/31IU, ALP 356 IU, uric acid 12.0mg/dL, serum protein 6.6mg/dL, Hb1Ac 13.5.X-ray chest was showing some infi ltrates and ECG revealed sinus rhythm. Urine was positive +++ for glucose and ketone bodies. Thyroid functions were normal andurine positive for bacteria and many pus cells. ABG revealed pH 6.88, pCO2 34, paO2 58, HCO3 6.8,BE 26, A-aO2 84. Child was ventilated and had pulmonary and GIT haemorrhage. No family history of diabetes mellitus.
Authors and Affiliations
Kundan Mittal, Sameer Aggarwal, H K Aggarwal, Neeraj Yadav, S Manazir Ali
Keywords
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- DOI 10.21304/2019.0601.00479
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