Question: You are called by a relatively inexperienced physician practising in a rural emergency department 3 hours from your centre. He has just admitted a

You are called by a relatively inexperienced physician practising in a rural

You are called by a relatively inexperienced physician practising in a rural emergency department 3 hours from your centre. He has just admitted a 22-year-old woman with type 1 diabetes who has confirmed diabetic ketoacidosis. On physical examination, she is oriented and in moderate distress. Vital signs are as follows: blood pressure 95/55 mm Hg, heart rate 110 bpm, respiratory rate 22/min, temperature 37.2C; oxygen saturation is 99% on 2 L O/min via nasal prongs. The physical examination is otherwise non-contributory. Initial laboratory investigations reveal the following results: pH 7.1 pCO 24 mm Hg pO2 99 mm Hg (99%) HCO3 8 mmol/L Na 145 mmol/L K 4.4 mmol/L CI 107 mmol/L Urea 25 mmol/L Creatinine 130 mol/L Glucose 30 mmol/L 1a. List FOUR general goals of initial treatment. (total marks, 4) 1b. List THREE items of general information that you will provide to the physician about managing the patient as her glucose level normalizes. (total marks, 3)

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