Case 1
An 18-month-old girl presents with abdominal pain, vomiting and drowsiness for one week. Her parents report she has also been drinking more than normal and is once again wetting the bed. On examination she is alert, tachycardic (HR180) but normotensive with dry mucous membranes, sunken eyes and a CRT of 3-4 seconds. Her peripheral pulses are weak and thready.
Exam Summary
0 of 5 Questions completed
Questions:
Information
You have already completed the exam before. Hence you can not start it again.
Exam is loading...
You must sign in or sign up to start the exam.
You must first complete the following:
Results
Results
Time has elapsed
Categories
- Not categorized 0%
- 1
- 2
- 3
- 4
- 5
- Current
- Review
- Answered
- Correct
- Incorrect
-
Question 1 of 5
1. Question
What are the initial management priorities?
CorrectIncorrect -
Question 2 of 5
2. Question
She responds well to 20 ml/kg fluid resuscitation and stabilises. She passes urine. Her blood gas results are:
pH 7.15, pC02 3.5, HCO3 5, BE -15, Na 135, K 5.0, Glu 36, blood ketones are 4.9
What are the management priorities now?
CorrectIncorrect -
Question 3 of 5
3. Question
Her weight is 10kg. Her pH is 7.0 on the initial blood gas. She has passed urine after the initial 20ml/kg fluid bolus. She is no longer shocked.
Write a prescription for the appropriate fluid & insulin therapy at this point.
CorrectIncorrect -
Question 4 of 5
4. Question
Bloods taken 2 hours into her treatment reveal:
pH 7.1, pCO2 3.6, HCO3 5, BE -15, Na 136, K 3.9, Glu 32, blood ketones are 4.8
What could be the underlying cause?
CorrectIncorrect -
Question 5 of 5
5. Question
You check her infusion site. It appears to have tissued. Her biochemical state gradually improves over the next few hours once a new cannula is inserted.
At 12 hours her bloods are as follows: pH 7.2, pC02 4.2, HCO3 10, BE -8, Na 138, K 3.6, Glu 12, blood ketones are 3.3
Write a prescription for the appropriate fluid & insulin therapy at this point.
CorrectIncorrect