final deck

Question 1

Red flags for CAP and severity score

Answer 1

RR 22
HR 100
Hypotension
sats < 92%
acute onset confusion
multilobar involvement

C - acute confusion
R - RR 30
B - hypotension
65 years old

Question 2

hypoglycaemia unconscious 8

Answer 2

1. 1mg glucagon im stat
2. 20ml 50% glucose via secure antecubital canula (10% in children)
3. 000 stating “diabetes emergency”
4. stay with patient until aambulance arrives
5. When regains full consciousness and can swallow give oral source of carboydrates
6. check BGL 15 minutely until > 4
7. Test BGL again 1 hour after emergency to ensure stable glucose levels
8. can’t drive for 6 weeks

Question 3

thirst
abdo pain
polyuria
polydipsia
nausea and vomiting 
weight loss
moderate - severe dehydration

Answer 3

capillary glucose > 15
ketones > 1.5 (or urine ketones moderate to heavy)
-> refer
if child refer if symptoms and BGL elevated

Question 4

Typical symptoms of DKA 5

Answer 4

1. polyuria
2. polydipsia
3. abdo pain
4. nausea and vomiting
5. LOW

Question 5

Classical signs of DKA 5

Answer 5

1. altered conscious state
2. kausmaul breathing
3. rapid RR
4. dehydration
5. ketotic breath

Question 6

classic symptoms of hyperosmolar hyperglycaemic state 4

Answer 6

1. polyuria
2. polydipsia
3. abdo pain
4. nausea and vomiting

Question 7

classical signs hyperosmolar hypperglycaemic state 2

Answer 7

1. dehydration

2. nausea and vomiting

Question 8

T2DM on insulin sick day mx

Answer 8

1. monitor BGLs 2-4 hourly
2. have enought needles
3. see GP if 2 or more consecutive BGL >15
4. may need to increase morning intermediate or long active insulin dose by 10-20%
5. if on ultra long acting insulin e.g. degludec seek advice as will take 4-7 days for dose to take effect
6. additional blood ketone ttesting may be incorporated if there are symptoms suggestive of ketosis (N&V, SOB, abdo pain, altered consciousness), hx of DKA or using and SGLT2 inhibitor
7. May need additional rapid acting insulin to use as a supplemental insulin dose
8. If not eating but feel weel and continue usual activities may need to reduce insulin to avoid hypoglycaemia