Severe DKA – altered consciousness — RACP Paediatrics MCQ

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ModerateEmergencySevere DKA – altered consciousnessRACP Paediatrics

A 10-year-old presents with altered consciousness, Kussmaul breathing, and a fruity odour on the breath. Blood glucose is 35 mmol/L. pH is 7.05. Ketones are 7.0 mmol/L. What is the cause of the altered consciousness?

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Correct answer: B — Blood glucose check

Altered consciousness with hyperglycaemia, severe metabolic acidosis (pH <7.1), and marked ketonuria/ketonaemia is severe DKA. Cerebral oedema should also be considered if consciousness does not improve with initial DKA treatment. DKA management should follow the standardised protocol with careful fluid management to minimise cerebral oedema risk.

Reference: RCH Melbourne – 2023 – DKA CPG; RACP Paediatric Curriculum – Emergency/Endocrine