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pedia - DM & DKA
med22
| Question | Answer |
|---|---|
| What is the definition of Diabetes Mellitus (DM)? | DM is a chronic, metabolic disease characterized by elevated levels of blood glucose (hyperglycemia) and glycosuria. |
| What is the primary cause of Type 1 Diabetes Mellitus (T1DM)? | Autoimmune destruction of the insulin-producing B cells of the pancreas, leading to permanent insulin deficiency. |
| What are the two peak ages for the incidence of Type 1 Diabetes (T1D)? | A peak at 4-6 years of age and a second peak at about 10-14 years of age. |
| List the four classic symptoms that constitute the presentation of new-onset Type 1 Diabetes (T1D). | Polyuria, polydipsia, polyphagia, and weight loss. |
| What is the definition of the "Honeymoon Period" in Type 1 Diabetes? | A period of stable blood glucose control where remaining functional Beta cells recover with insulin treatment, causing exogenous insulin requirements to decrease, often lasting 3-6 months. |
| What is the long-term HbA1c goal set for children of all ages with Type 1 Diabetes? | HbA1c below 7.5%. |
| What fasting serum glucose level is diagnostic for Diabetes Mellitus (DM)? | A fasting serum glucose concentration of 126 mg/dL or above. |
| What HbA1c level is diagnostic for Diabetes Mellitus (DM)? | A Hemoglobin A1c (HbA1c) of 6.5% or above. |
| What are the three criteria that define Diabetic Ketoacidosis (DKA)? | Hyperglycemia (BG > 200mg/dL), Venous pH < 7.30 or bicarbonate < 18 mmol/L with an anion gap, AND Ketonemia (Beta-hydroxybutyrate >= 3 mmol/L) or ketonuria. |
| How is the severity of Diabetic Ketoacidosis (DKA) classified as "Severe" based on venous pH and bicarbonate? | Severe DKA is defined by a Venous pH of < 7.1 and a Bicarbonate level of < 5 mEq/L. |
| What is the cause of Kussmaul respirations in DKA? | Respiratory compensation for metabolic acidosis, resulting in tachypnea with deep respirations. |
| What is the initial fluid resuscitation step in DKA management for a patient in shock? | Give 20 ml/kg (maximum 1 L) IV 0.9% NaCl over 30 minutes. |
| When should insulin infusion be started during DKA management? | At 60-120 minutes after starting the first fluid bolus (but only if the potassium level is >= 3.5 mmol/L). |
| When should potassium be added to the IV fluids during DKA management? | Add potassium only after the patient's first void and if the potassium level is equal to or less than 5.5 mmol/L. |
| When should dextrose (glucose) be added to the IV fluids during DKA management? | When blood glucose drops to less than 17 mmol/L (or if blood glucose is decreasing by > 5 mmol/L/hr after insulin infusion). |
| What is the most serious complication of DKA and its treatment? | Cerebral edema and cerebral herniation. |
| List three uncontrollable risk factors for cerebral edema in DKA management. | Younger age (< 5 years), New onset diabetes, Longer duration of symptoms, Severe hypocapnia, or Severe acidosis. |
| List three controllable risk factors for cerebral edema in DKA management. | IV bicarbonate treatment, Administration of insulin in the first hour of fluid treatment, Greater volume of fluid given in the first 4 hours, or Corrected serum sodium dropping or not rising with treatment. |
| What dermatologic manifestation is noted as a sign of hyperinsulinism and insulin resistance in Type 2 Diabetes? | Acanthosis nigricans, presenting as hyperkeratotic pigmentation in the nape of the neck and flexural areas. |
| What is the first-line oral agent for the management of new-onset, uncomplicated Type 2 Diabetes in most children? | Metformin. |
Created by:
MeanHeem