skip to main content

Cerebral oedema in paediatric DKA — RCPSC EM MCQ

Instant feedback + full explanation. One question, done properly.

HardPaediatric emergenciesCerebral oedema in paediatric DKARCPSC EM

During treatment of paediatric DKA, a 35-kg child develops bradycardia, rising BP, headache and declining GCS. What should be given before neuroimaging?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: C — Give hypertonic saline or mannitol now, reduce fluids, and call critical care

Explanation lettering: E = shown as A · A = shown as B · B = shown as C · C = shown as E

B is correct for suspected cerebral injury and treatment must precede imaging. C does not treat cerebral injury and bicarbonate can be harmful. D gives hypotonic rapid fluid. E risks hypovolemia without treating the mechanism. A delays osmotherapy and loss of compensatory hyperventilation may worsen cerebral acidosis.

Reference: Canadian Paediatric Society, Current recommendations for paediatric DKA: https://cps.ca/en/documents/position/current-recommendations-for-management-of-paediatric-diabetic-ketoacidosis