Metobolic

Question 1

What is the appropriate approach to insulin administration in DKA?

Answer 1

Eval K level first, then give 0.1 U/kg/hr gtt

Question 2

Treatment for DKA followed by new AMS or seizure

Answer 2

Cerebral edema, more common in kids and new onset type I, Tx give mannitol (1-2g/kg)

Question 3

What is the appropriate treatment for Thyrotoxicosis?

Answer 3

1) Antihormone treatment with PTU or Methimazole (blocks new hormone synthesis)
2) Potassium Iodine (AFTER above, blocks release of preformed hormone)
3) Block systemic effects with Propranolol and Steroids (prevents peripheral conversion T4->T3)
4) Treat precipitant
5) Prevent Decompensation (IVF, tylenol, cool prn)

Question 4

Rx for Hyperkalemia

Answer 4

Treatment is calcium gluconate, insulin, albuterol, bicarbonate

Question 5

What is the initial treatment of choice for hypercalcemia?

Answer 5

Aggressive hydration with normal saline

Question 6

Dextrose should be given BEFORE OR AFTER thiamine for the theoretical prevention of Wernicke-Korsakoff syndrome

Answer 6

after