Endocrine and diabetes medicines OSCE — DKA insulin and fluid prescribing with family counselling

Candidate brief

You have 10 minutes. ^[4]

1. Sequence the immediate fluid and insulin prescribing for this child's diabetic ketoacidosis, including the insulin infusion rate and the rule on insulin boluses. ^[4]
2. Explain to the examiner why insulin — not fluids or bicarbonate — is the definitive treatment, and why a steep glucose fall is avoided. ^{[4] [9]}
3. Outline the transition from intravenous insulin back to a subcutaneous regimen, including the insulin classes you would choose. ^[1]
4. Explain the pump-failure and sick-day safety plan to her mother in language she can repeat back. ^[1]