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First Aid for the USMLE Step 1 (2021)
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Page 355 -

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First Aid for the USMLE Step 1 (2021) | Physician Assistant (PA) School Study Aid

Page 355 -
5 Picmonics to Learn | 9 mins
Diabetes Assessment
Assessment Type 1
Juvenile Onset
Absent Insulin Production
Ketosis Prone
Assessment Type 2
Adult Onset
Insulin Resistance
Obesity
Gestational Diabetes
Onset During Pregnancy
Glucose Intolerance
Complications
Retinopathy
Peripheral Vascular Disease
Nephropathy
Neuropathy
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2 mins
Diabetic Ketoacidosis (DKA) Signs and Symptoms
Kussmaul respirations
Dehydration
Abdominal Pain
Nausea/vomiting
Psychosis
Fruity breath Odor
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1 min
Diabetic Ketoacidosis (DKA) Diagnosis and Labs
Diagnosis
Blood glucose Increased > 250 mg/dL
Anion gap metabolic acidosis
Decreased pH < 7.3
Decreased serum bicarbonate < 18
Plasma ketones
Other Labs
Hyperkalemia
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1 min
Diabetic Ketoacidosis (DKA) Treatment
Initial Management
IV Normal Saline
Regular Insulin Drip
Subsequent Management (correction of electrolytes)
Potassium (K+)
Glucose
Treat Underlying Cause
Monitoring
Venous pH
Serum Bicarbonate (HCO3)
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1 min
Hyperosmolar Hyperglycemic State
Characteristics
Insulin Present
Increased Serum Osmolality
Glucose >600 mg/dL
No Significant Acidosis or Ketosis
Clinical Features
Severe Dehydration
Altered Neurological Status
Tachycardia and Hypotension
Management
IV Fluids
Insulin
Treat Underlying Disorder
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3 mins

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