A 2-year old is admitted to the pediatric with acute onset of Type 1 diabetes mellitus and diabetic ketoacidosis. Diabetic ketoacidosis results from an excessive accumulation of which of the following?
Release of sodium bicarbonate from renal compensation
Ketone bodies from fat metabolism
Excretion of excess potassium from cellular death
Elevated glucose from elevated insulin
The Correct Answer is B
A. Release of sodium bicarbonate from renal compensation: In response to metabolic acidosis, the kidneys may attempt to compensate by excreting hydrogen ions and retaining bicarbonate ions. However, this mechanism does not contribute to the development of diabetic ketoacidosis.
B. Diabetic ketoacidosis (DKA) is a serious complication of diabetes mellitus, particularly type 1 diabetes, resulting from a relative or absolute deficiency of insulin. In the absence of sufficient insulin, the body cannot properly utilize glucose for energy, leading to increased lipolysis (breakdown of fat) and subsequent production of ketone bodies (such as acetone, acetoacetate, and beta-hydroxybutyrate) as an alternative fuel source. The accumulation of ketone bodies in the blood lowers the blood pH, leading to metabolic acidosis characteristic of DKA.
C. Excretion of excess potassium from cellular death: Diabetic ketoacidosis can lead to electrolyte imbalances, including hyperkalemia due to shifts of potassium out of cells as acidosis worsens. However, this is a consequence of DKA rather than a primary cause.
D. In type 1 diabetes mellitus, there is an absolute deficiency of insulin, leading to hyperglycemia. Elevated glucose levels contribute to the osmotic diuresis seen in DKA, but they are not the primary cause of ketoacidosis.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
The practice as it helps prevent the backflow of stomach contents into the esophagus, which is beneficial for infants with gastroesophageal reflux.
B. This statement does not necessarily indicate an understanding of the teaching. Breast milk or formula can be used for infants with reflux; however, some formulas are designed to be easier to digest or less likely to cause reflux.
C. This is not generally recommended for infants with reflux. The safest position for all infants, including those with reflux, is on their back to reduce the risk of sudden infant death syndrome (SIDS).
D. This may be recommended in some cases to help reduce the symptoms of reflux. However, it's important to do this under the guidance of a healthcare provider to ensure it's done safely and appropriately. Thickening formula should be done with caution as it can increase the risk of choking.
Correct Answer is ["A","B","C","D"]
Explanation
These findings indicate that the child is experiencing significant pain, which is concerning, especially considering the history of sickle cell anemia and the recent increase in pain despite previous management with acetaminophen. Chest pain could also be indicative of a vaso-occlusive crisis or a respiratory complication.
Nasal flaring and moderate subcostal and substernal retractions are noted:
Nasal flaring and retractions suggest increased work of breathing, which could indicate respiratory distress. In a child with sickle cell anemia, respiratory complications like acute chest syndrome are a significant concern during a vaso-occlusive crisis.
Bilateral, moderate inspiratory and expiratory wheezes noted upon auscultation:
Wheezing indicates airway obstruction or inflammation, which could be due to asthma exacerbation, infection, or acute chest syndrome, all of which are common complications in children with sickle cell disease.
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