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Diabetic Ketoacidosis in Children

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Instructions for template Answer is the prompt that the learners will see. Question will be the correct response. To enter your questions and answers, click once on the text on the slide. –Highlight and type over whats there to replace it. –Using Delete or Backspace may cause the text box to disappear. To move to the next appropriate slide, place your cursor over a hand, not an arrow. –If you place your cursor over a text box, it will be an arrow and will not take you to the right location.

More instructions... Clicking on a question value will take you to the answer prompt. When no more questions are available, click on Category A. The text box for Category A contains a hyperlink to the Final Jeopardy slide. The answer slide for Final Jeopardy contains an action box (sound) that can act as a timer (thinking music from Jeopardy).

Jeopardy Rules The team member buzzing in will answer Discussion is allowed only with final jeopardy All responses must be phrased as questions Wrong questions will be penalized the value of the question The judges decisions and ad hoc rules, however pigheaded and uninformed, are final Gratuitous abuse of the judge will be penalized

Choose a category. You will be given the answer. You must give the correct question. Click to begin.

Click here for Final Jeopardy

Thats Sweet! Its All In Your Head My Stomach Aches 10 Point 20 Points 30 Points 40 Points 50 Points 10 Point 20 Points 30 Points 40 Points 50 Points 30 Points 40 Points 50 Points Picture Potpourri Vomitings & Diarrhea

This is the first line therapy for management of most children with AGE

What is ORT - Oral rehydration therapy (at 30ml/kg/hr)

These are the 2 most common viral etiologies for gastroenterities in children

What are Rotavirus and Adenovirus

Bilious emesis in a child is suspicious for this condition (Hint: Describe where the anatomical lesion is)

What is Obstruction, distal to ampulla of vater

This bacterial cause of gastroenteritis is commonly known to be associated with febrile seizures

What is Shigella

These are the 4 signs that are most helpful in predicting dehydration

What are 1. CR>2s 2. Absent tears 3. Dry mucous membranes 4. General appearance (ill appearance)

This is the leading cause of mortality in children with diabetes

What is DKA (Cerebral edema is the leading cause of mortality in DKA)

This is the % deficit assumed in patients with DKA

What is 10% (100 mL/kg)

Hypoglycemia in neonates is managed by giving this solution (Hint: Name the solution and volume)

What is 5 to 10 mL/kg bolus, administered IV or IO (0.5 to 1 g/kg/dose)

Metabolic emergencies in infants often present with nonspecific features that may mimic more common conditions like sepsis. These are the 3 most common signs & symptoms found in metabolic emergencies

What are Vomiting, altered mental status, and poor feeding

A type 1 diabetic presents in DKA Her labs are: Glucose - 650mg/dl, and Na - 131meq/l This is her corrected sodium…

What is 140 meq/L (Correct reported sodium by adding 1.6 meq/L for every 100mg/dl of serum glucose over normal)

This disease usually presents in infancy with delayed passage of meconium or chronic constipation, but can be missed and present later in childhood

What is Hirschsprung Disease

This neonate presented with bilious vomiting Describe the X ray, and name the genetic condition most commonly associated with this anomaly

What is -Double bubble sign (Duodenal atresia) -Trisomy 21 (Nearly 40%)

This is an abdominal sonogram of a 4 month old infant with vomitings Describe the finding, and name the diagnosis

What is Target sign or donut appearance; This is typical of Intussusception

This adolescent presented with an oval lesion as shown along with a more generalized rash Name one differential diagnosis and treatment

What is Secondary Syphilis Symptomatic treatment

This lesion was noticed on the thigh of a toddler who presented with a seizure Name the lesion and the condition associated with this lesion

What is Ash leaf macule (a well demarcated hypopigmented macule) Tuberous sclerosis

A 4 year old girl having a GTC seizure, has not responded to 2 doses of Ativan. This is your next step… (ABCs, oxygen, d-stick and IV access/labs have been done).

What is Load with Fosphenytoin PE/kg IV)

These are the 3 characteristics associated with complex febrile seizures

What are -Focal seizures -Duration >15 minutes -Two or more seizures in a 24 hour period

A 3 year old with a 3 day h/o vomiting and diarrhea has a GTC seizure. Temp: 103 F D-stick & shock panel: normal Describe her diagnosis and management

What is Simple febrile seizure No additional work-up needed

A 10 year old with a 7 month h/o throbbing headaches, associated with nausea and photophobia has a normal neurological exam This is what you would do next… (Hint: Mom has a h/o headaches)

What is Treat for migraine headache No imaging necessary

The most common cause of headaches in children is _(a)_, but keep in mind these _(b)_ worrying symptoms which should prompt further work-up (name at least 7)

What is (a)viral illness (b) Features suggesting secondary pathology: headaches on awakening or disrupting sleep new onset (< 6months) changes in behavior, personality, or school performance change in characteristics of headache vision disturbances (by hx or exam) abnormal neuro exam unusual locations (occipital) younger age (< 6 yo), neck stiffness exacerbated by changes in posture, coughing, or sneezing endocrine changes (precocious puberty, abnormal growth)

A 3 week old male infant presents with vomiting for several days Labs: Na 131, K 2.5, Cl 82, HCO3 31, Glucose 48, VBG: pH=7.52 Name the most likely diagnosis

What is Pyloric stenosis (Hypokalemic hypochloremic metabolic alkalosis)

A 3 year old male with a 2 day h/o intermittent abdominal pain & vomiting, and the following rash This is the most likely diagnosis

What is HSP (Henoch Schonlein Purpura)

A 3 week old male with a 4 hour h/o progressively bilious vomiting, fussiness, and abdominal distension. The stool guaiac is positive Name the diagnostic study of choice

What is Upper GI series

A 3 y.o.male with intermittent abdominal pain, lethargy… Name the most likely diagnosis

What is Intussusception

A 3 wk old male with a 3 day h/o vomiting, poor feeding, decreased wet diapers, and sleeping more than usual Labs: Na 126, K 7.5, Cl 81, HCO3 11 Glu 40mg/dl, VBG: pH 7.21 Name the most likely diagnoses

What is Congenital Adrenal Insufficiency

Make your wager

List at least 4 phone extensions to the Pediatric ER (KCHC only)

What are, 3638, 3860, , 3643, 1435