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  #1  
Old 07-09-2012
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Question DKA kid...admit or dont admit

During a routine visit to the pediatrician, a 10-year-old boy is found to have a random blood glucose of 220mg/dL. Upon further questioning, his mother reports that he always seems thirsty and has lost several pounds over the past few months, both of which she had attributed to the start of daily basketball and track practices. A urine dipstick in the office shows 4+ glucose and 2+ ketones. His initial lab studies show Na+ 132, K+ 3.7, Cl- 110, HCO3- 15, glucose 220, BUN 18, creatinine 0.5. No other laboratory or physical abnormalities are noted. Based on this information, which of the following is the most appropriate initial step in patient care?


A. Admit patient to the hospital to start IV fluids and subcutaneous insulin
B. Begin treatment with subcutaneous insulin injections
C. Check a fasting blood glucose
D. Measure HbA1c levels to confirm the diagnosis
E. Recommend dietary supplements to prevent further weight loss
EXPLN! !!!!
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Old 07-10-2012
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B?

Since we are given a choice to start treatment, HBA1c doesn't make much sense because its never useful in gauging a Type 1 who isn't being treated.
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Old 07-11-2012
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ans is B. i thought that DKa patient ALWAYS need hospital admission but qbank expln says that this kid does not need so... any one having better idea ..why so ?
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Old 03-18-2013
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Quote:
Originally Posted by tyagee View Post
ans is B. i thought that DKa patient ALWAYS need hospital admission but qbank expln says that this kid does not need so... any one having better idea ..why so ?
A. would admit. Afraid of potassium dropping.
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Old 03-18-2013
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The child is not presenting a DKA, he was found to be presenting the high glucose levels on a routine visit. Therefore no need to admit to hospital and ran other tests or diets, only start treatment.

If the child was at the ER or visit to office due to presenting symptoms of DKA, yes admit to hospital.
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Old 03-19-2013
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DKA symptoms are not presenting in this child to admit.....so B would be the answer...

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