Case Studies An 18-year-old male high school student who had a 4-year history of diabetes mellitus was brought to the emergency department because of excessive drowsiness, vomiting. and diarrhea. His diabetes had been well controlled with 40 units of NPH insulin daily until several days ago when he developed excessive thirst and polyuria. For the past 3 days, he has also had headaches, myalgia, and a low-grade fever. Diarrhea and vomiting began 1 day ago Chemistry Test Results Sodium 126 mmol/L Urinalysis Results Specific 1.012 gravity pH 5.0 Glucose 4+ Ketone Large Potassium Chloride Bicarbonate Plasma glucose 6.1 mmol/L 87 mmol/L 6 mmol/L 600 mg/dL BUN Creatinine Serum ketones 48 mg/dL. 2.0 mg/dL 4+ 1. What is the probable diagnosis of this patient 2. What laboratory test(s) should be performed to follow this patient and aid in adjusting insulin levels? 3. Why are the urine ketones positive? 4. What methods are used to quantitate urine ketones? Which ketone(s) do they detect?
Case Studies An 18-year-old male high school student who had a 4-year history of diabetes mellitus was brought to the emergency department because of excessive drowsiness, vomiting. and diarrhea. His diabetes had been well controlled with 40 units of NPH insulin daily until several days ago when he developed excessive thirst and polyuria. For the past 3 days, he has also had headaches, myalgia, and a low-grade fever. Diarrhea and vomiting began 1 day ago Chemistry Test Results Sodium 126 mmol/L Urinalysis Results Specific 1.012 gravity pH 5.0 Glucose 4+ Ketone Large Potassium Chloride Bicarbonate Plasma glucose 6.1 mmol/L 87 mmol/L 6 mmol/L 600 mg/dL BUN Creatinine Serum ketones 48 mg/dL. 2.0 mg/dL 4+ 1. What is the probable diagnosis of this patient 2. What laboratory test(s) should be performed to follow this patient and aid in adjusting insulin levels? 3. Why are the urine ketones positive? 4. What methods are used to quantitate urine ketones? Which ketone(s) do they detect?
Introduction to General, Organic and Biochemistry
11th Edition
ISBN:9781285869759
Author:Frederick A. Bettelheim, William H. Brown, Mary K. Campbell, Shawn O. Farrell, Omar Torres
Publisher:Frederick A. Bettelheim, William H. Brown, Mary K. Campbell, Shawn O. Farrell, Omar Torres
Chapter30: Nutrition
Section: Chapter Questions
Problem 30.35P
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Case Studies An 18-year-old male high school student who had a 4-year history of diabetes mellitus was brought to the emergency department because of excessive drowsiness, vomiting. and diarrhea. His diabetes had been well controlled with 40 units of NPH insulin daily until several days ago when he developed excessive thirst and polyuria. For the past 3 days, he has also had headaches, myalgia, and a low-grade fever. Diarrhea and vomiting began 1 day ago Chemistry Test Results Sodium 126 mmol/L Urinalysis Results Specific 1.012 gravity pH 5.0 Glucose 4+ Ketone Large Potassium Chloride Bicarbonate Plasma glucose 6.1 mmol/L 87 mmol/L 6 mmol/L 600 mg/dL BUN Creatinine Serum ketones 48 mg/dL. 2.0 mg/dL 4+ 1. What is the probable diagnosis of this patient 2. What laboratory test(s) should be performed to follow this patient and aid in adjusting insulin levels? 3. Why are the urine ketones positive? 4. What methods are used to quantitate urine ketones? Which ketone(s) do they detect?
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