Diabetic Ketoacidosis (DKA) Case Study Latest
update 2024 Diana Humphries, 45 years old
(Solved)
Which plane do the neck and body of the pancreas lie on? - ANSWER: Transpyloric
plane
What major blood vessel is located between the head and uncinate process of the
pancreas? - ANSWER: Superior Mesenteric Artery
Where is pancreatic pain referred to? - ANSWER: The lumbar spine (dermatomes T6
to T10)
Where does the transverse mesocolon attach to the pancreas? - ANSWER: it attaches
alongside the body of the pancreas in the transpyloric plane
What are the relations of the pancreas? - ANSWER: Ileum
Antrum
Transverse Colon
Stomach
Spleen
Jejunum
Pylorus
What is the blood supply of the pancreas? - ANSWER: Mainly supplied by the splenic
artery but the head is supplied by the pancreato-duodenal arteries
Venous drainage is mirrored
What are the 4 parts of the duodenum? - ANSWER: Superior
Descending
Horizontal
Ascending
What is the paraduodenal recess? - ANSWER: The peritoneum over the inferior
mesenteric vein is raised slightly to the left and forms a fold/recess called the
paraduodenal recess.
What are the anterior relations of the duodenum? - ANSWER: Gallbladder
SMA/Vein
Greater Omentum
Liver
What are the posterior relations of the duodenum? - ANSWER: Aorta
IVC
, Portal Vein
Hepatic Duct
Kidney
How is the spleen connected to the stomach and the kidney? - ANSWER: by the
greater omentum
What abdominal organ has the highest incidence of injury? - ANSWER: The Spleen,
which usually ruptures due to its fibroelastic capsule breaking under pressure
What is Kuss-maul breathing? - ANSWER: a deep and labored breathing pattern
often associated with severe metabolic acidosis (DKA or Kidney Failure)
What is the normal range of finger prick BGL? - ANSWER: <11.1 mmol/L
What is the normal range of ketones in the blood? - ANSWER: <0.6 mmol/L
What type of hormone is insulin and where is it produced? - ANSWER: peptide
hormone produced by beta-cells of the pancreas.
What effects does insulin have on a cellular level? - ANSWER: Stimulates cell division
Increases Protein Synthesis
Increases Glycogen Synthesis
Inhibits Hormone Sensitive Lipase
all done via tyrosine kinase receptor
What are the systemic effects of insulin? - ANSWER: Inhibits Glucagon Release
Reduces Blood Glucose Levels
Reduced Fat breakdown
Increased glucose intake into cells
Why is an absolute insulin deficiency an essential factor in diabetic ketoacidosis? -
ANSWER: The presence of insulin inhibits the formatio of ketones and so absolute
deficiency is required to lead to ketoacidosis (this is more commonly present in type
1)
How does dehydration occur in Diabetic Ketoacidosis? - ANSWER: Insulin deficiency
leads to reduced uptake of glucose by cells
This mimics a state of hypoglycaemia even if glucose is present in the blood
This releases catabolic hormones that raise BGL even further
This leads to glycosuria/polyuria causing dehydration and worsening acidosis
How are ketone bodies formed in diabetic ketoacidosis? - ANSWER: Lack of insulin
suppression allows the use of triglycerides for energy
update 2024 Diana Humphries, 45 years old
(Solved)
Which plane do the neck and body of the pancreas lie on? - ANSWER: Transpyloric
plane
What major blood vessel is located between the head and uncinate process of the
pancreas? - ANSWER: Superior Mesenteric Artery
Where is pancreatic pain referred to? - ANSWER: The lumbar spine (dermatomes T6
to T10)
Where does the transverse mesocolon attach to the pancreas? - ANSWER: it attaches
alongside the body of the pancreas in the transpyloric plane
What are the relations of the pancreas? - ANSWER: Ileum
Antrum
Transverse Colon
Stomach
Spleen
Jejunum
Pylorus
What is the blood supply of the pancreas? - ANSWER: Mainly supplied by the splenic
artery but the head is supplied by the pancreato-duodenal arteries
Venous drainage is mirrored
What are the 4 parts of the duodenum? - ANSWER: Superior
Descending
Horizontal
Ascending
What is the paraduodenal recess? - ANSWER: The peritoneum over the inferior
mesenteric vein is raised slightly to the left and forms a fold/recess called the
paraduodenal recess.
What are the anterior relations of the duodenum? - ANSWER: Gallbladder
SMA/Vein
Greater Omentum
Liver
What are the posterior relations of the duodenum? - ANSWER: Aorta
IVC
, Portal Vein
Hepatic Duct
Kidney
How is the spleen connected to the stomach and the kidney? - ANSWER: by the
greater omentum
What abdominal organ has the highest incidence of injury? - ANSWER: The Spleen,
which usually ruptures due to its fibroelastic capsule breaking under pressure
What is Kuss-maul breathing? - ANSWER: a deep and labored breathing pattern
often associated with severe metabolic acidosis (DKA or Kidney Failure)
What is the normal range of finger prick BGL? - ANSWER: <11.1 mmol/L
What is the normal range of ketones in the blood? - ANSWER: <0.6 mmol/L
What type of hormone is insulin and where is it produced? - ANSWER: peptide
hormone produced by beta-cells of the pancreas.
What effects does insulin have on a cellular level? - ANSWER: Stimulates cell division
Increases Protein Synthesis
Increases Glycogen Synthesis
Inhibits Hormone Sensitive Lipase
all done via tyrosine kinase receptor
What are the systemic effects of insulin? - ANSWER: Inhibits Glucagon Release
Reduces Blood Glucose Levels
Reduced Fat breakdown
Increased glucose intake into cells
Why is an absolute insulin deficiency an essential factor in diabetic ketoacidosis? -
ANSWER: The presence of insulin inhibits the formatio of ketones and so absolute
deficiency is required to lead to ketoacidosis (this is more commonly present in type
1)
How does dehydration occur in Diabetic Ketoacidosis? - ANSWER: Insulin deficiency
leads to reduced uptake of glucose by cells
This mimics a state of hypoglycaemia even if glucose is present in the blood
This releases catabolic hormones that raise BGL even further
This leads to glycosuria/polyuria causing dehydration and worsening acidosis
How are ketone bodies formed in diabetic ketoacidosis? - ANSWER: Lack of insulin
suppression allows the use of triglycerides for energy
