Question

A previously healthy 18-year-old man is brought to the emergency department because of abdominal pain and nausea for 6 hours. He has had decreased appetite for the past week. He takes no medications. He drinks one to two beers daily and occasionally more on weekends. He does not use illicit drugs. His temperature is 37.8°C (100°F), pulse is 120/min, respirations are 24/min, and blood pressure is 105/60 mm Hg. Abdominal examination shows diffuse tenderness with no guarding or rebound. Bowel sounds are normal. Laboratory studies show:SerumNa+ 135 mEq/LCl− 98 mEq/LK+ 3.8 mEq/LHCO3− 16 mEq/LGlucose 360 mg/dLKetones presentUrine ketones presentArterial blood gas analysis on room air shows a pH of 7.30. Which of the following is the most likely diagnosis?(A) Acute appendicitis(B) Acute pancreatitis(C) Alcoholic ketoacidosis(D) Diabetic ketoacidosis(E) Lactic acidosis

Answer 1

The boy is presenting a (D) DIABETIC KETOACIDOSIS

Step-by-step explanation:

Diabetes appears when our pancreas (an important organ in metabolism) can´t produce enough insulin or that the pancreas isn’t working normal maybe for destruction of it mediated by antibodies, which could have sense in this case of a young boy of 18 years old who according to the case, probably has a diabetes type 1. We can say that for those levels of glucose (360) and the presence of ketones and urine ketones that his body is suffering a decompensation called diabetic ketoacidosis. It is a dysregulation of metabolism in which the patient presents high levels of glucose in circulation but how there’s no necessary insulin to enter glucose to the cells, the body starts to produce ketones as other molecules to obtain the energy for daily activities. A ketoacidosis explains the disbalance and diminution of ph, and his other symptoms.A diabetic ketoacidosis is a medical emergency and needs to be carefully attended. In this case, the ketoacidosis was the first sign of diabetic tipe 1 disease.