QuestionSBA
QuestionChoice
This answer is incorrect. Whilst sepsis will need to be excluded in hospital, this patient is more likely to have DKA due to his hyperglycaemia and high ketones in the context of type 1 diabetes.
10007400
e
Sepsis
QuestionChoice
This answer is incorrect. Patients with acute appendicitis usually present with severe pain in the right iliac fossa. Appendicitis would not explain his high blood ketones.
10007398
c
Acute appendicitis
QuestionChoice
This answer is incorrect. Whilst his symptoms fit with acute alcohol intoxication, this would not explain his hyperglycaemia and ketonuria.
10007397
b
Alcohol intoxication
QuestionChoice
This answer is correct. Diabetic ketoacidosis (DKA) is a medical emergency. It occurs most commonly in type 1 diabetics and presents with hyperglycaemia, ketonaemia, and acidosis. It can be precipitated by a number of causes, including an alcohol binge and forgetting to take insulin.
10007396
a
Diabetic ketoacidosis
QuestionChoice
This answer is incorrect. Hyperosmolar hypoglycaemic state (HHS) typically occurs in people with type 2 diabetes. Patients have very high blood sugars, but no ketones.
10007399
d
Hyperosmolar hyperglycaemic state
Concept
Chapter
2693
4005
Diabetic ketoacidosis
Topic
133
Endocrinology
14026
One night, an 18-year-old student with type 1 diabetes goes out clubbing with his friends. Before going out, he drinks 8 cans of beer and he accidentally forgets to take his usual insulin after dinner.


In the club, he starts to feel unwell. He feels dizzy and begins to vomit. His friends decide to to call an ambulance.


The paramedics measure his capillary blood glucose and ketones:


 * Glucose - 42 mmol/L (normal <6.1 mmol/L)
 * Ketones - 5 mmol/L (<0.6 mmol/L)


Which of the following is the most likely diagnosis?
a