Need to write a CASE STUDY for the following. (answers required for all 5 parts)

Question

Need to write a CASE STUDY for the following. (answers required for all 5 parts)

Chief Complaint: RM an 8-year-old girl is taken to the local clinic and presents with excessive thirst, frequent urination, and weight loss History: RM, an 8-year-old girl in previously good health, has noticed that, in the past month, she is increasingly thirsty. She gets up several times a night to urinate, and finds herself gulping down glassfuls of water. At the dinner table, she seems to be eating twice as much as she used to, yet she has lost 5 pounds in the past month. In the past three days, she has become nauseated, vomiting on three occasions, prompting a visit to her pediatrician Questions 1. At the doctor's office, blood and urine samples are taken. The following lab results are noted blood glucose level 545 mg/dl (normal 50 170 mg/dl) blood pH level 7.23 urine tested positive for glucose and for acetone /acetoacetate (i.e. ketone bodies) (normally urine is free of glucose and ketone bodies) (normal - 7.35 - 7.4) A. Based on objective findings above (i.e., lab values), what disease state could RM be experiencing? B. There are two different types of this disease. Name both types of this disease and provide a brief description of each addressing age of onset and pathophysiology of each. Include in your answer(s) the organ and cell-type involved and any changes that might occur in the organ or cell-type or peripheral tissues C. What type of this disease leads to the above signs and symptoms? (i.e., what type does RM have?) D. Why is her blood-glucose level elevated? E. Why would her blood pH level be decreased? F. At the office, RM is breathing rapidly and taking deep breaths. What physiological purpose does this serve? G. RM has a fruity odor to her breath. What is causing this and what is the condition called? H. Explain why RM is urinating so frequently?

Explanation / Answer

1

A. Type 1 diabetes

B. Type 1 diabetes can develop at any time during childhood, usually begins between 4 years and 6 years or between 10 years and 14 years. In the type 1 diabetes the pancreatic insufficiency occurs due to autoimmune effects. Due to the autoimmune effect the insulin-producing beta cells in the pancreas are damaged.

Type 2 diabetes is characterized by the insulin resistance to utilize the insulin produced by the pancreas, losing its ability to respond to insulin. The body will produce more insulin in response to the insulin resistance but eventually the beta cells fail.

C. RM has Type 1 diabetes.

Occurred in childhood.

With increase in ketone bodies.

Glucose in urine

D. Increase in Acetone a type of ketone causes fruity smell of breath

Also known as acetone breath or “nail polish remover breath.”

H. The occurrence of osmotic diuresis to eliminate the increased glucose levels in body results in polyuria.

I. Diabetes mellitus metabolically mimics starvation in which the lipids and proteins are metabolized for energy. The Ketone body production by the liver is dependent on the insulin:glucagon ratio . The decrease in this ratio for several days results in ketone body production increase.

2.

A. The main danger of insulin administration in hypoglycemia. To counteract it RM should carry a candy always in hand. The unit of insulin “Unit , U”. U100 means 100 units of insulin in 1 ml

B.RM has insulin deficiency due to lack of insulin production occurred as result of pancreatic insufficiency. Insulin injection is used to treat type 1 DM.

Drugs are used in Type 2 DM with insulin resistance.

3.

A.

Glycosylated hemoglobin or A1C measures the percentage of blood sugar attached to the oxygen-carrying protein in red blood cells (hemoglobin).

Glycosylated hemoglobin or A1C level of 6.5 percent or higher on two separate tests indicates diabetes.

B. It can predict the glucose tolerance or management of previous weeks.

4.

A.Heart and blood vessel disease

Diabetic neuropathy

Diabetic nephropathy

Retinal damage

Foot or peripheral neuropathy

Pregnancy complications.

B. The possible complications of peripheral neuropathy results in foot damage which will not be noticed easily by RM due to decreased sensations.

Related Questions

Navigate

• Browse (All)
• Browse N
• Subjects

---

---

Integrity-first tutoring: explanations and feedback only — we do not complete graded work. Learn more.