CLIPP 16: 7 year old with abdominal pain and vomiting

Question 1

GCS: eye score

Answer 1

4- Eyes open spontaneously
3- Eyes open to verbal command
2- Eyes open to pain
1- No eyes opening

Question 2

GCS: verbal response scoring

Answer 2

5- Oriented
4- Confused, able to answer questions
3- Inappropriate words
2- Incomprehensible words
1- No verbal response

Question 3

GCS: Motor scores

Answer 3

6- Obeys commands
5- Localizes pain
4- Withdraws from pain
3- Abnormal flexion: decorticate posture
2- Extensor response: decerebrate posture
1- No motor response: flaccid

Question 4

Presenting symptoms of DKA?

Answer 4

Vomiting, vague abdominal pain, tachycardia

Question 5

What causes abdominal pain in DKA?

Answer 5

Acidosis

Question 6

When can you add serum potassium for someone in DKA?

Answer 6

When the potassium levels are known

Question 7

Why get a CBC for someone with DKA?

Answer 7

Look for signs of infection as the nidus for DKA

Question 8

At what blood glucose levels does osmotic diuresis begin?

Answer 8

180

Question 9

What causes catecholamine release in DKA?

Answer 9

Decreased intravascular volume

Question 10

Sodium levels in isotonic dehydration

Answer 10

130-150

Question 11

How fast should you administer fluids to recover a deficit?

Answer 11

In general, fluids should rarely exceed 1.5-2x maintenance rate

Question 12

BPs in cerebral edema?

Answer 12

High

Question 13

Heart rate in cerebral edema?

Answer 13

Bradycardia

Question 14

Three antibodies to assess for a patient in DKA?

Answer 14

anti-pancreatic antibodies (insulin, GAD, IA2)
Thyroid antibodies
Anti-endomysial and tissue transglutaminase antibodies with serum IgA antibodies

Question 15

The ADA also recommends that every child with new-onset type 1 diabetes be screened for what additional disease at diagnosis

Answer 15

Celiac Disease