Growth Gone Wrong
What hormone is deficient in a child with short stature and delayed growth?
Growth hormone (somatotropin)
This lab value is often falsely low in DKA due to fluid shifts, even though the total body amount may be normal. It helps maintain fluid balance in the body and is a key part of the BMP.
Sodium (NA)
Why is it inappropriate to increase the insulin infusion rate solely to lower serum potassium in DKA?
A) It causes hyperglycemia
B) It may cause hypoglycemia and other complications
C) It increases potassium levels
D) It has no effect on potassium
?
It may cause hypoglycemia and other complications
PKU is caused by the absence of what enzyme?
Phenylalanine hydroxylase
What is the normal HbA1C target for a child under 6 years old?
Less than 8.5%
What diagnostic test confirms GH excess?
Oral Glucose Tolerance Test (OGTT)
What blood glucose value indicates hypoglycemia in a child?
Less than 60 mg/dL
What is the initial priority intervention in DKA management?
Administer isotonic IV fluids
What odor is associated with PKU?
Musty or “mousy” odor in urine
When mixing insulin, which type is drawn up first?
Short-acting (clear) before intermediate (cloudy)
What is the most common cause of GH deficiency in children?
Idiopathic or pituitary dysfunction
Which statement about Kayexalate use in DKA is true?
A) It is first-line treatment for hyperkalemia in DKA
B) It acts quickly to reduce potassium levels
C) It is reserved for persistent hyperkalemia not responding to fluids and insulin
D) It should be given before insulin therapy
C) It is reserved for persistent hyperkalemia not responding to fluids and insulin
At what blood glucose level should you add glucose to IV fluids?
When blood glucose approaches 250 mg/dL
Infants with this autosomal recessive disorder may first present with an exaggerated Moro reflex and mild hypotonia, gradually lose head control and sitting ability by 6–12 months, and often develop seizures and blindness by age 2.
Tay Sachs Disease
What teaching should parents know about PKU diet initiation?
Begin dietary restrictions within 7–10 days after birth
Name one expected finding in GH deficiency.
Short stature, delayed dentition, increased insulin sensitivity
Why should insulin injection sites be rotated?
To prevent lipohypertrophy and ensure consistent absorption
What acid-base imbalance occurs in DKA?
Metabolic acidosis
What is the main treatment for Galactosemia?
Lifelong elimination of galactose/lactose from the diet
How often should height be measured in a child with GH deficiency?
Every 6 months under age 3, yearly after that
What is a key teaching point for somatropin therapy?
Administer via subcutaneous injection 6–7 days/week and monitor growth regularly
Name two hallmark symptoms of hyperglycemia.
Polyuria, polydipsia, polyphagia (any two)
Why must potassium be closely monitored in DKA?
Insulin therapy drives potassium into cells, risking hypokalemia
What metabolic disorder causes urine to smell like maple syrup?
Maple Syrup Urine Disease (MSUD)
What is the expected blood pH in DKA?
Less than 7.30