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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Related Questions
Correct Answer is D
Explanation
Celiac disease is an autoimmune disorder characterized by an intolerance to gluten, a protein found in wheat, barley, rye, and their derivatives. Therefore, the appropriate food choices for a child with celiac disease are those that are gluten-free.
A. Ric (presumably referring to rice) - Rice is gluten-free and is an appropriate choice for individuals with celiac disease.
B. Wheat - Wheat contains gluten and should be avoided by individuals with celiac disease.
C. Barkey (presumably referring to barley) - Barley contains gluten and should be avoided by individuals with celiac disease.
D. PRIOHOUS - serves as a mnemonic to remember gluten-free food choices (e.g., potatoes, rice, oats, corn, fruits, vegetables, meat, fish, poultry, eggs, dairy products). These foods are typically safe for individuals with celiac disease.
Correct Answer is A
Explanation
A Wilms' tumor is a common kidney cancer that primarily affects children. One of the classic signs of this tumor is the presence of a large abdominal mass, which may be palpable upon physical examination and hematuria (pink-tinged urine).
B. Intussusception is a condition where a part of the intestine folds into another section, causing an obstruction. The symptoms can include episodes of severe abdominal pain, vomiting, bloody stools, and lethargy.
C. Nephritic syndrome is a renal condition characterized by inflammation. The symptoms often include hematuria, hypertension, and oliguria.
D. Pyloric stenosis is a condition where the distal opening of the stomach is obstructed due to smooth muscle hypertrophy. It presents with projectile vomiting after feeding, dehydration, and weight loss.
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