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Pediatric DKA cerebral edema — ABEM Board MCQ

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HardPediatric emergenciesPediatric DKA cerebral edemaABEM Board

A 12-year-old girl with DKA becomes more somnolent during ED treatment. Triage acuity is ESI 1; BP 142/86 mm Hg, HR 108/min, RR 24/min. She has headache, vomiting, and a new sixth nerve palsy. Glucose is falling gradually. Which of the following is the most likely diagnosis?

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Correct answer: D — Cerebral edema complicating diabetic ketoacidosis

Headache, declining mental status, cranial nerve palsy, and hypertension during pediatric DKA treatment suggest cerebral edema.

Reference: ISPAD pediatric DKA guidance