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lec35 Case study:Adil's Hyperglycemia

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Michael Baker

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BCH210H1LECTURE 35Case Study Adils Hyperglycemia1Effects of No Insulin2Ketone Bodies and Ketogenesis3Effects of Adils Insulin InjectionCase Study Adils HyperglycemiaYour friend Adil a 21 year old male in LMP is an excellent student but lately has not been doing well at allYou have noticed that he comes to class very tired and complains of lack of energyRecently he seemed to have a bout of fluhe was nauseated and this has lasted a weekYou are quite concerned as Adil has lost weight even the upcoming BCH 210 final could not account for thisAnd how he drinks oLots and lots of water and CokeoHe drinks a bottle for each lecture you attend togetherHes also urinating a lotExams are coming up but Adil has had difficulty studying and is feverishYou ask him to see your GP but he says hell wait to see his own Doctor in OakvilleIts the last lecture and Adil just gets to BCH 210 and begins to take notesoHes sitting beside you and you notice a funny fruity smell on his breath as well as a half eaten donut hes brought with him for breakfastFunny smellacetone being produced Just before the lecture Adil begins to sway back and forth vomits and passes outHes breathing but you cant wake him upoPassed out and still breathing concern about blood sugarYou dial 911 on your cellThe paramedics arrive check that he is breathing and take Adil and you to the Emergency Room at the Toronto GeneralThey read Adils BP as 9060 12080 normal and note his deep sighing respirationoHypotensiveblood pressure is low At the ER the resident checks Adils breathingoAdil is now breathing more rapidly deeply and noisilyAdil is still unconsciousThe resident takes a urine sample by catheter and using a Dipstick shows Adils urine is strongly positive for both glucose and ketone bodiesShe asks if Adil is diabetic or has diabetic relativesoYou say you are not aware of thisShe notes that he has a fever and is obviously dehydratedAdil has no MedicAlert bracelet so not diagnosed for this disease beforeShe takes a blood sample from Adil and sends it off for lab analysis1
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