OSCE - Learning Points 177

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OSCE- Learning Points Diabetic Ketoacidosis 

1. How is DKA causing Pre- Renal AKI? 

  Diabetic Ketoacidosis 

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Nocturnal Diuresis 

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Dehydration 

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Hypovolemia 

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Acute Kidney Injury 

2. Can it be Renal Etiology? 

Yes it can be due to Renal Etiology, existing diabetes cause release of free radicals causing PCT atrophy and damage causing Diabetic Tubulopathy 

3. Causes and treatment of Tachypnea? 

Tachypnea is a condition that refers to rapid breathing. The normal breathing rate for an average adult is 12 to 20 breaths per minute.

Tachypnea does not necessarily have a pathological cause. For example, exercise can cause tachypnea. Some pathological causes of tachypnea are sepsis, diabetic ketoacidosis, respiratory issues such as pneumonia, carbon monoxide poisoning, pulmonary embolism, pleural effusion, asthma, or chronic obstructive pulmonary disease (COPD). Other medical issues such as allergic reactions, anxiety states, and foreign body aspiration can also cause tachypnea.

4. Link between LVF and COPD?

Ledt sided heart failure is most often caused by high blood pressure or coronary artery disease. It’s not directly related to COPD. But the two conditions may influence each other.

For example, low oxygen in blood from COPD may put extra strain on your heart which worsens left sided heart failure. And too much fluid in your lungs from heart failure can make breathing even harder if you have COPD

5. Treatment for Diabetic Ketoacidosis? 

• Replacing fluids you lost through frequent urination and to help dilute excess sugar in your blood.

• Replacing electrolytes (minerals in your body that help your nerves, muscles, heart, and brain work the way they should). Too little insulin can lower your electrolyte levels.

• Receiving insulin. Insulin reverses the conditions that cause DKA.

• Taking medicines for any underlying illness that caused DKA, such as antibiotics for an infection.

Learning Points: 

  -I’ve learnt the importance of a detailed personal history to come to the final diagnosis.  

-I’ve learnt that how can diabetes leads to major complications if ignored.

-I’ve learnt how a detailed history and examination can lead to the diagnosis.
-I’ve learnt how does diabetic Ketoacidosis can lead to various other systemic infections.
- I’ve learnt how to differentiate copd disease with heart failure. 
- I’ve learnt how to approach diabetic Ketoacidosis in terms of management 
-I’ve learnt how to reach a probable diagnosis by taking a good patient oriented history.