Diabetes emergency and prescribing safety
PLAB pack: medication safety SBA
Theory
Theory 1: Station focus
Diabetes emergency tests glucose interpretation, ketone risk and safe prescribing.
- Glucose, ketones and hydration.
- Vomiting, abdominal pain, infection trigger.
- Insulin use and missed doses.
Theory 2: Reasoning path
The priority is to distinguish hypoglycaemia, DKA/HHS and medication error.
- Identify the immediate risk.
- Choose the safest first action.
- Explain why the distractors are weaker.
Theory 3: Expected output
The candidate should check glucose/ketones, assess dehydration and start the correct emergency pathway.
- Capillary glucose.
- Blood ketones/VBG.
- Fluids, insulin pathway and senior review.
Vocabulary and model dialogue
Doctor: Have you missed any insulin doses, and have you checked ketones?
Patient: I missed yesterday's dose and my ketones are high.
Doctor: This may be diabetic ketoacidosis, so we need urgent treatment.
Practice
Practice 1: Stem analysis
A young adult with type 1 diabetes has vomiting, abdominal pain, high glucose and positive ketones.
Output: Age, timing, symptoms, vital risk and one missing question.Practice 2: First action
Choose the first safe action: Assess ABCDE, check ketones/VBG and start DKA pathway with senior review.
Output: One action plus clinical reason.Practice 3: Differential
Compare Diabetic ketoacidosis with two alternatives.
Output: Three-line differential table.Practice 4: Exam response
Write the emergency assessment and patient explanation.
Output: Assessment + explanation.Interactive tasks
Interactive 1: Red-flag sort
Sort findings from "Diabetes emergency and prescribing safety" into urgent and non-urgent details.
Interactive 2: Distractor removal
Remove the least plausible option from: Simple gastritis only, Routine medication refill, Migraine without metabolic check.
Interactive 3: Timed response
Give a 90-second exam answer using the station output steps.
Quiz
The combination strongly suggests DKA and needs emergency treatment.
The safest answer addresses the immediate clinical risk first.
Exam documentation must record the detail that changes management.
Safe exams include patient understanding and escalation advice.
The station expects a short, defensible clinical chain.