Alcoholic ketoacidosis

A 38-year-old man with a history of binge drinking presents to the emergency department with abdominal pain, nausea, and vomiting. He reports consuming large amounts of alcohol over the past four days and has not been able to eat. On examination, he is tachycardic and tachypnoeic. His observations are: heart rate 108 bpm, respiratory rate 24 breaths per minute, blood pressure 105/65 mmHg, and temperature 37.0C. Blood tests reveal a high anion gap metabolic acidosis, with elevated blood ketones and normal glucose levels.

What complication should be closely monitored in this patient during treatment?

A 55-year-old woman with chronic alcohol use presents with confusion, vomiting, and abdominal pain. She has not eaten for three days but continued to drink alcohol. On examination, she is disoriented and tachypnoeic. Her observations are: heart rate 120 bpm, respiratory rate 28 breaths per minute, blood pressure 100/60 mmHg, and temperature 36.7C. Blood tests show: glucose 3.9 mmol/L, bicarbonate 14 mmol/L, sodium 136 mmol/L, potassium 4.2 mmol/L, chloride 102 mmol/L, and blood ketones 3.8 mmol/L. Serum osmolality is elevated.

What additional treatment should be considered to prevent neurological complications?

A 45-year-old woman with alcoholic ketoacidosis is receiving intravenous fluids and thiamine. The clinician emphasizes the importance of managing electrolyte levels during her treatment.

Which of the following electrolytes is particularly important to monitor and manage in patients with alcoholic ketoacidosis?

A 50-year-old woman recovering from an episode of alcoholic ketoacidosis is advised on long-term management strategies to prevent recurrence.

Which of the following long-term management strategies is most important for preventing recurrence of alcoholic ketoacidosis?

A 50-year-old woman with a history of heavy alcohol consumption presents to the emergency department with severe nausea, vomiting, and generalized weakness. She has not eaten for several days. On examination, she is tachypnoeic and appears dehydrated. Her observations are: heart rate 115 bpm, respiratory rate 26 breaths per minute, blood pressure 95/60 mmHg, and temperature 36.8C. Blood tests show: glucose 4.8 mmol/L, bicarbonate 12 mmol/L, sodium 138 mmol/L, potassium 3.5 mmol/L, chloride 99 mmol/L, and blood ketones 4.5 mmol/L.

What is the first-line treatment for this condition?