Emergency Medicine Journal 2008;25:705
© 2008 BMJ Publishing Group Ltd and the College of Emergency Medicine.
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- True. Urine dipstick testing is 97% (95% CI 92% to 99%) sensitive for ketonaemia in DKA.1 Mild ketonuria is found in the normal fasting state, therefore the test is not specific.
- True. The mean difference between arterial and venous pH in DKA is 0.015–0.05.2–4 An arterial blood gas analysis should be considered in suspected respiratory failure when an accurate measurement of carbon dioxide is required.3 5
- False. Leucocytosis is often found in DKA without infection.6 7 However, an infective cause should always be sought.
- False. Cerebral oedema is much more common in those patients less than 20 years old. However, a large study of children found no association with the rate or type of intravenous fluid replacement.8 Factors associated with cerebral oedema were high blood urea and low initial carbon dioxide, indicating more severe disease. Given the poor prognosis of this complication, most authors concede that once treatment for shock and oliguria
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