Question

21 year old male seen in the ED for the following symptoms; he is, hot, flush, complaining of thirst, states he has been "peeing" a lot. He is lethargic, though arousable, has a fruity breath odor and his friends who brought him in say that he has been binging all weekend on beer and tequila at various parties. He is thin, almost cachexic in appearance.

Vital Signs: BP 90/40, HR 120, RR 35. Urine is very pale, water like. The patient arouses enough to tell you that he has been a insulin dependent diabetic since age 10 and he had left his insulin at home in another city where he lives with his parents. His usual daily dose is NPH 15 u with 5 units of regular every morning, and 10 units of NPH at bedtime. His serum blood glucose is 500 mg/dL; a glycated hemogloblin is 10. Other labs are: serum creatinine 2.0; BUN 25; Serum potassium of 4.0

3. Explain two of the psychological components that may be present in this person that causes the behavior that triggered his current problem.

4. Which of labs indicate that he has problems in other organs most likely related to his diabetes?

Answer 1

3. Psychological components:

1. Above case indicates hyperglycemia with insulin dependent diabetes.

This may cause fatal psychological or neurological complications like

1. Severe dehydration with come

2. Swelling of brain tissues

This leads to irritability, restless and altered sensorium

Diabetes may cause diabetes stroke.

And this also may leads to depression.

Question 4.

Lab result:

Creatinine level increased. That is 2. ( normal 0.6 - 1.2)

This indicates renal damage.

Common organ involved is renal or kidney.