Chapter·ManagementDKA

Electrolyte management (particularly potassium)Downloads

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1

A 17-year-old male presents to your office complaining of polyuria, polydipsia, and unintentional weight loss of 12 pounds over the past 3 months. On physical examination, the patient is tachypneic with labored breathing. Which of the following electrolyte abnormalities would you most likely observe in this patient?

AHypophosphatemia

BHypermagnesemia

CHyperkalemia

DHyponatremia

EHyperphosphatemia

2

A 16-year-old woman presents to the emergency department for evaluation of acute vomiting and abdominal pain. Onset was roughly 3 hours ago while she was sleeping. She has no known past medical history. Her family history is positive for hypothyroidism and diabetes mellitus in her maternal grandmother. On examination, she is found to have fruity breath and poor skin turgor. She appears fatigued and her consciousness is slightly altered. Laboratory results show a blood glucose level of 691 mg/dL, sodium of 125 mg/dL, and elevated serum ketones. Of the following, which is the next best step in patient management?

AAdminister IV fluids and insulin

BInitiate basal-bolus insulin regimen

CInitiate insulin glargine 10 units at bedtime only

DInitiate oral antidiabetic medications

EInitiate insulin aspart at mealtimes only

3

An 8-year-old boy is brought to the emergency department with severe dyspnea, fatigue, and vomiting. His mother reports that he has been lethargic for the last several days with an increase in urine output. She thinks he may even be losing weight, despite eating and drinking more than normal for the last couple weeks. Laboratory results are notable for glucose of 440, potassium of 5.8, pH of 7.14 and HCO3 of 17. After administrating IV fluids and insulin, which of the following would you expect?

AIncrease in anion gap

BIncrease in serum glucose

CDecrease in serum potassium

DDecrease in pH

EDecrease in serum bicarbonate

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