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 D
Explanation
A. Neuroblastoma is a type of cancer that arises from immature nerve cells and commonly affects infants and young children. While it can occur in the abdomen, it is not primarily a renal tumor.
B. Ewing sarcoma is a type of bone cancer that primarily affects children and adolescents. It typically arises in the bones of the pelvis, legs, arms, ribs, or spine. While it can involve the abdominal area if it metastasizes (spreads), it is not primarily an intra-abdominal tumor.
C. Osteosarcoma commonly arises in the long bones of the arms and legs. While it can spread to other parts of the body, including the abdomen, it is primarily a bone tumor.
D. Wilms' tumor, also known as nephroblastoma, is the most common malignant renal (kidney) tumor of childhood. It typically occurs in children around 2 to 5 years old and is often detected as a firm, non- tender abdominal mass.
Correct Answer is D
Explanation
A. 15 angle is for intradermal injection not for intramuscular
B. The needle should be inserted into the middle third of the deltoid muscle, which is typically 2 to 3 finger widths below the acromion process.
C. A smaller gauge needle, such as 22 or 23, is often used for pediatric vaccinations to minimize discomfort. This should, however, be adjusted accordingly based on individual characteristics
D. Ashorter needle length, such as 1.8 mm (0.5 in), is typically appropriate for pediatric deltoid injections to avoid deep penetration
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