study_ing
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in an obtunded pt in whom we arent aware of the DM tyoe, how do we figureout whether the pt has DKA or nonketotic hyperglycemic hyperosmolar coma?
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| Mars-Aris
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Urine ketones.
if urinalysis (+) for ketones --> DKA
if negative --> HNKC
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| study_ing
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urinalysis wasnt mentioned in the q at all..what else??
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| saadtazjam
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hey guys can we tell with the pattern of the breathing?The patient is comatose,after blood sugar????
Kussumal-DKA
any thoughts?
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| study_ing
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cud be.actually i was thinking about the pH ..i think it wud be lower in DKA, and the glucose levels..shud be really high in hyperosmolarrather than DKA. ..anion gap i think wud point more towards DKA
i know these can occur in both but they just tend to favor a given dx more than th eother.. any discussion /correction wud be appreciated.
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| study_ing
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i guess fruty odor--DKA
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| tolito
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i think those are all the differentiating factors if the blood chemistry is not given. plus if patient is a young person, then it is more likely DKA.
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| study_ing
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hmm so in summary
- history--age
- P/E---fruity odor, kaausmall breathing?
- lab--blood pH ( LOWER favors DKA)
- anion gap
- serum ketones
- Urinary ketones
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