Question

Latanya is a 24-year-old woman, admitted in the hospital yesterday with a chief complaint of increase urination and excessive thirst. Her symptoms began six months back. Prior to that time, she voided approximately about three to four times per day. She is now voiding about 8 - 10 times per day. She feels tired and dizzy at work. Three days back she visited ER for altered mental status.

O/E: She had severe dehydration, blood pressure 90 / 50 and heart rate was 135 / minute. In the ER some blood and urine tests were done, two bags of 0.9% NaCl (saline) i.v fluid were infused and her blood pressure was stabilized. She was discharged from the ER at about 11:00 PM, last night. She was advised to see her physician for follow-up check-up in a week, but she was admitted again at 9:00 AM today because of excessive urination and dizziness. She has a family history of high blood pressure, cancer, diabetes, depression and heart disease. She lives alone in a high-rise building in downtown. She has master’s degree in literature. She is a smoker and occasionally drinks alcohol with friends at party. There is no history of drugs abuse. No sexual history available. There is no history of surgery or hospitalization available. Patient was observed to have an intense craving for ice water at the time of first admission in ER last night. She denied any change in her appetite in the ER. She is not taking any prescription medications. She also denied the use of any herbs or over the counter medicines, other than Tylenol for headaches occasionally or for menstrual pain.

Gravida 0, Para 0. LMP March 12. Ht: 5’6” wt 135lbs but has lost about 6lbs in the last two weeks.

She is moderately dehydrated, BP 95/60, pulse 130/min, T 98.6F (37C), mental status drowsy but conscious.

Identify the possible causes of her condition.

Answer 1

The cause is diabetes. She has all the sign and symptoms of diabetes like-

1) excessive urination. For this body become dehydrated and she feels thirsty.

2) she is feeling tired and dizzy because glucose is not able to enter into the cell and for these cells are not producing proper energy.

3) has low bp and high pulse because due to dehydration there is hypovolemia in the blood, cause low bp and because there is low volume, the heart will get low amount of blood and for this, it will beat faster so that it can pump more amount of blood so pulse rate will high.

4) there is a sign of weight loss also which is obvious in diabetes.

5) she has a family background with diabetes.