A 14 year old with 2 week history of being unwell and weight loss. Clinical signs were suggestive of DKA. The clinical signs were identified and discussion on differential diagnosis with appropriate clinical justification was good. Management was discussed briefly.

Learning points:

• Read up current management guidelines for DKA management
• Consider basic things first.
• Differential diagnosis – ensure our fundamentals are correct
• History and examination question – be specific and sleek
• Think what will help you narrow DD and reach your diagnosis
• DO NOT suggest full system examination
• Investigations – think AS IF you are managing in the WARD
• Do NOT forget basic investigations – FBC, U&Es, Bl Gases.
• DO NOT mention an investigations if you cannot discuss it i.e. Anion gap.
• SUGGEST read Management of all ACUTE presentations