Sallie is a 15yearold female that is brought to the emergenc

Sallie is a 15-year-old female that is brought to the emergency room by her frightened gym teacher. Sallie was playing soccer outside and had a syncopal episode. Sallie is now conscious but is breathing very fast, complains of being very thirsty and feeling very nauseous. On assessment you notice that her skin is redder than usual, dry and hot to the touch.

Lab values:

Na 138, K 5.5, Cl 105, Glucose 575

pH 7.25, CO2 30, HCO3 8.0

Evaluate the lab values (normal, high, low)

Na: Normal

K: High

Cl: Normal

Glucose: High

pH: Low

CO₂: Low

HCO₃: Low

2.List 3 differential diagnoses and include your reasoning behind each.

3.What is the best diagnosis? Explain how you came to this conclusion.

4.What other findings may be present with this patient?

Solution

2. Juvenile Diabetes as the girl is 15yrs old and blood glucose is higher than normal, acidosis as hco3 and co2 are low and blood is acidic, Hyperkalemia as K ions are high.

3. The best diagnosis is juvenile diabetes. Blood became acidic due to the presence of ketone bodies, diabetic ketoacidosis, syncopy, thirst are symptoms of diabetes.

4.the patient may be having polydipsia, polyuria and pilyphagia.