#POV
#POV You’re The Doctor (Pediatrics): Season 3, Episode 6
Created with Tyler Beauchamp, medical student & author
#doctor #pediatrics #doctor #medicine #healthcare #medschool #premed #medstudent #jakegoodman
Disclaimer:
My content is for educational and marketing purposes and should not be used in place of therapy or treatment
Answer: A – give diuretics + fluids
This patient has most likely developed Reye Syndrome, a complication seen in kids given aspirin. It most often happens when kids are given aspirin when sick, especially with a virus, as viruses cause aspirin metabolites to build up in the liver. The swelling injures the liver (as seen with increased liver enzymes and acidosis), which can lead to increased swelling around the brain (confusion/altered mental status/severe vomiting). In cases like these, it’s best to give patients fluids (with sugar) to replace all they’re losing from vomiting, as well as give osmotic diuretics to decrease brain pressure. While this may look like new onset diabetes and DKA with their vomiting and confusion, the patient’s blood sugar would be elevated not lowered (Answer B). The meds the father gave were most likely aspirin, which would be the root cause of this presentation, so giving aspirin would only worsen symptoms (Answer C).
References:
Glasgow JFT, Middleton B. Reye syndrome: insights on causation and prognosis. Archives of Disease in Childhood . 2001; 85(5): p.351-353