smitha
Forum Elite
Topics: 53
Posts: 236
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[B]A pt. with DKA is being treated with human insulin.During therapy,the pt.develops respiratory paralysis requiring intubation & assissted vetilation.Which of the following is the mechanism for the pt.'s resp. failure???
1.An anaphylactic reaction to penicillin
2.Glucose toxicity
3.Ketoacidosis
4.Hypophosphatemia
5.Hyperkalemia
and plz. try to xplain the basis of ur answer too..................
:wink:
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| usmlebuzz
Forum Elite
Topics: 93
Posts: 263
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hypophospatemia is a common cause of neuromuscular dysfunction in DKA
recovering patient due to influx of phosphate (just like K+) in the hungry cells. : :!:
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| Delusional
Forum Elite
Topics: 41
Posts: 226
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Actually, it is only common in patients with low serum phosphate due to alcohol abuse or malnourishment and not in a patient with DKA per se.
A drop of Phosphate < 2.5mg/dl doesn't usually give the above picture ....it has to go below 1.5mg/dl
If asymptomatic and not so low then no need to treat but if sever and very low then IV phosphate might be needed.
Okay here goes the next question.......this patient has DKA and let us assume his K+ becomes low = 2.5 meq/l ..... and he develops this picture of Acute hypophosphatemia.......
you send for his phosphate and K+ thinking that his K+ might be so low that it might be the cause of the muscle weakness....
The result comes to be Phosphate = 1 mg/dl and
K+ = 6.5 mEq/l
WHAT IS HAPPENING TO OUR POOR PATIENT? :shock: :shock:
And please like smitha says be elaborate in ur suggestions and views.... 
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| zaki
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hypophosphatemia is a very rare complication of dka in real life and usualy pt with dka doesnot reqd phosphate supplement but in this qs and given choices hypophosphatemia is a right choice to pick up and hyperkalemia does not show that pic as delusion is trying to complicate the issue, hyperkalemia leads to arrythmias first rather then causing respiratory musles paralysis
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| guest
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guys u all r wrong.....
dka itself causes respiratory depression and respiratory arrest.....
so its the ketoacidosis responsible for the respiratory arrest.....yes evewn in real life dear zaki........
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| Hosam
Forum Newbie
Topics: 4
Posts: 21
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I think it is hypophosphatemia.
Dear Smitha, could you tell us the right answer, and why?
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| Delmar
Forum Senior
Topics: 24
Posts: 158
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simply KETOACIDOSIS...hey guys dont be eccentric
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