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  #1  
Old 08-28-2011
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Pancreas Clinical Features of Type I Diabetes

A 15-year-old child with known type I DM is seen in the ER for increasing abdominal pain. On exam he appears confused and is observed breathing rapidly and deeply. Which of the following findings is consistent with this child’s condition?
A. Hypoglycemia
B. Decreased ketogenesis
C. Metabolic alkalosis
D. Non-anion gap acidosis
E. Intracellular potassium depleted
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Old 08-28-2011
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it should be E, dKA
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Old 08-28-2011
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yap it E)..INTRACELLULAR K DEPLETED..
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Old 08-28-2011
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going with e
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Old 08-28-2011
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Definitely E is the best answer!
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Old 08-29-2011
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acidosis? D!
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Old 08-29-2011
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Quote:
Originally Posted by salz View Post
acidosis? D!
D? Non-Anion GAp ? >> So you can remember the mneumonic is

M - Methanol
U - Uremic Synd
D - DKA

P-Phenytoin
I - INH and Iron Tablets
L - Latic Acidosis
E - Ethanol
S - SAlicilates

Those are Metabolic Acidosis with Anion Gap Increase....
So D is not the answer.

The right answer should be E, Depleted K... in DKA we find Increase Extracelular K and Decrease Intracellular K, as we recall K is main intracellular metabolite... in fact, we first address the K Problem and Insulin right away and give electrolyte over the treatment...

Just 2 cent..
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  #8  
Old 08-29-2011
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A > In fact labs shows Hyperglicemic pte
B > Patient is increase Ketogenesis due fatty breakdown. ( In fat we inverse the normal ratio from Acetoacetate to B-Hydroxybutyrate
C > Pte is metabolic acidosis actually.
D > i already explained.

E is look like the answer for me.
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Old 08-29-2011
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Ans- E. Intracellular potassium depleted

Reason: Insulin helps in intracellur uptake of potassium. DM 1 is def of insulin, so dec uptake --> leads to hyperkalemia.
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The correct answer is E.
The child is currently in diabetic ketoacidosis (DKA). His pattern of respiration is typical for Kussmaul respirations, which is an example of respiratory compensation for metabolic ketoacidosis. In this condition, there is increased anion gap acidosis due to production of ketone bodies. Although hyperkalemia may be seen in lab value, the child is actually intracellularly potassium depleted. Treatment involves aggressive intravenous hydration and exogenous insulin administration. Once the acidosis is corrected, the child will need potassium supplementation.
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Old 09-07-2011
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Quote:
Originally Posted by rulz View Post
D? Non-Anion GAp ? >> So you can remember the mneumonic is

M - Methanol
U - Uremic Synd
D - DKA

P-Phenytoin
I - INH and Iron Tablets
L - Latic Acidosis
E - Ethanol
S - SAlicilates

Those are Metabolic Acidosis with Anion Gap Increase....
So D is not the answer.

The right answer should be E, Depleted K... in DKA we find Increase Extracelular K and Decrease Intracellular K, as we recall K is main intracellular metabolite... in fact, we first address the K Problem and Insulin right away and give electrolyte over the treatment...

Just 2 cent..
ok so what is the diff between non-ionic and ionic metabolic acidosis? and i think there is metabolic acidosis in DM1 TOO cuz of ketoacidosis.. and yes the ans is depleted IC K!
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Old 09-07-2011
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Breathing rapidly + deeply = hyperventilation (+ hx of DM + altered consciousness = DKA

DKA = metabolic acidosis (kussmaul breathing), ketogenesis (beta-hydroxybutyrate, acetoacetate), ICF to ECF shift of K+ as a result of acidosis.

Answer E.

Tnx guys for MUD PILES. Would come in handy for step 1...
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