DB'S MEDICAL RANTS

Internal medicine, American health care, and especially medical education

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Diabetic ketoacidosis

The diagnosis is not tricky, but I do have a few questions:

 

Na 121 Cl 73 BUN 57 glu 1820
K 9.6 CO2 6 creat 3.2 Ca++
  1. Has anyone seen a higher glucose?
  2. A higher K?
  3. Postulate the sequence of events leading to these numbers

Background information – 17 year history of type I DM.  Several recent admissions for DKA, but usually with blood glucose lower than 1000.

ABG

pH 7.20
pCO2 17
pO2 324
calc HCO3 7
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