Today we’ll be covering Diabetic Ketoacidosis (DKA), going along with this month’s theme, Endocrinology. If you haven’t listened to our podcast before, each week we have a case-based discussion about a medical topic to help you study for the pediatric medicine board exam. Episodes are released every weekend, and the case is then reviewed and reinforced on social media throughout the week.
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A 12 year old male presents to the ED for abdominal pain and vomiting, starting today. He also reports feeling increasingly thirsty after getting better from his recent URI. On exam, patient is noted to have rapid, deep breathing, and his serum labs show a pH of 7.0, blood glucose 700, and BUN 50. Bicarbonate was given due to an undetectable serum CO2 value. Additionally, this patient’s corrected serum sodium failed to improve with initial therapies in the ICU. Which of the following are NOT associated with increased risk for cerebral edema in this patient?
- Initial serum glucose
- Decreased partial pressure of arterial CO2
- Treatment with bicarbonate
- Lack of increase in serum sodium during therapy
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