Deep Dive MW R4

Diabetic Ketoacidosis – hyperglycemia, ketosis, and anion gap metabolic acidosis Don’t forget about euglycemic DKA (especially in setting of SGLT2 inhibitor) or mimics such as alcoholic ketoacidosis Treatment of the ketoacidosis Insulin (usually a drip or bolus + drip) – only once K>3.5 Volume Resuscitation (NS initially, change to LR) Bicarb drip (poor evidence, only […]

Round 4 (MW) – Shortness of Breath

You are working a shift at Clerkship General when the charge nurse comes and grabs you to see a 24yo male who appears to be in respiratory distress. Critical Actions: Diagnose DKA Replete potassium Start insulin AFTER potassium repletion EITHER place central line for faster K repletion OR initiate bipap to allow time for potassium […]