🟢 Internal Medicine Boards High-Yield Video Series 2024 ( Medquest )

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Endocrine Board Review, 15th Edition 2023

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Williams Textbook of Endocrinology 15E ALGRAWANY 2025

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✅️Boards and Beyond Videos ▶️

? diabetic ketoacidosis

- DKA is an acute, life-threatening medical emergency that can occur in both type I and type II diabetic patients (more common in type I).

- Consequences of DKA include hyperglycemia, ketonemia, metabolic acidosis, and volume depletion

? Precipitating factors
- Any type of stress or illness (e.g., infection, trauma, myocardial infarction, stroke, surgery, sepsis,)
- Inadequate administration of insulin

?Diagnosis

- hyperglycemia
- ketonaemia
- metabolic acidosis
- Ketonemia and acidosis are required for the diagnosis of DKA.
- Hyponatremia
- hyperkalemia may be present initially,
although total body potassium is low. As insulin is given, it causes a shift of potassium into cells, resulting in a hypokalemia.

?Clinical features
- Symptoms usually occur rapidly, typically in less than 24 hours

- Nausea and vomiting
- rapid, deep breathing ( kussmaul's breathing) 
- Abdominal pain (more common in children) that may mimic acute abdomen
- “Fruity” (acetone) breath odor
- Marked dehydration, orthostatic hypotension, tachycardia—volume depletion is
always present
- Polydipsia, polyuria, polyphagia, weakness
- Altered consciousness, drowsiness, and frank coma may occur if not treated

? Management

- The aims of DKA management are to correct circulating volume and electrolyte imbalance

-  It is important to identify and treat precipitating causes as well as to prevent complications.

- management of DKA include : intravenous insulin,
intravenous fluid (normal saline)
potassium replacement

- finally refer to a diabetes specialist

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