A 10-year-old child presents with polyuria, weight loss, vomiting, and abdominal pain. He is dehydrated and breathing deeply. Glucose is 29 mmol/L,

Question

A 10-year-old child presents with polyuria, weight loss, vomiting, and abdominal pain. He is dehydrated and breathing deeply. Glucose is 29 mmol/L, pH is 7.18, bicarbonate is 9 mmol/L, and ketones are positive. What is the most appropriate next step in management?

Accepted Answer

Begin paediatric DKA protocol with isotonic fluids and intravenous insulin

Answer

Treat with oral metformin and discharge

Answer

Give rapid fluid boluses until glucose normalises

Answer

Administer bicarbonate routinely

Answer

Start subcutaneous long-acting insulin alone

Paediatric diabetic ketoacidosis — MCCQE Part 1 MCQ

A 10-year-old child presents with polyuria, weight loss, vomiting, and abdominal pain. He is dehydrated and breathing deeply. Glucose is 29 mmol/L, pH is 7.18, bicarbonate is 9 mmol/L, and ketones are positive. What is the most appropriate next step in management?