Need to write a CASE STUDY for the following data. Chief Complaint: RM an 8-year

Question

Need to write a CASE STUDY for the following data.

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

A) Diabetic ketoacidosis. Diabetic ketoacidosis is seen in the patient who is suffering of diabetes type 1.

B) There are 2 types of diabetes

1. Diabetes type 1: Age of onset of this disease is below 40 and is more prevalent in the children.

Pathophysiology: Unable to produce sufficient insulin due to autoimmune destruction of beta cells in pancreas which helps to produce insulin and to regulate blood glucose level.

2. Diabetes type 2: Age of onset of this disease is middle aged and in older age(45-65)years.

Pathophysiology: The body either produces inadequate amount of insulin to meet the demand of the body or impaired regulation of glucose production and declining beta cell function. In this case, the insulin resistance has also developed when cells do not respond to insulin in case of elevate level of glucose.

The organ pancreas and beta cells are involved in the production normal level of insulin.

C) Type -1 diabetes leads to the above signs and symptoms.

D) In this disease, elevation of blood glucose level occurs due to insufficient production of insulin, which controls the glucose level by signaling the liver, muscle and fat cells to take in glucose from blood. Insulin helps cells to take in glucose to be used for energy.

E) In this disease, due to insufficient insulin production blood glucose uptake by the cells is low to use the energy for glucose metabolism. So to meet the demand of energy body uses fat as the source of energy instead of glucose which causes the accumulation of acidic byproduct ketones in the body. Thus results in production of excess hydrogen ion to binds with bicarbonate which decreases serum bicarbonate level and becomes acidic. As the ketone level increases the body becomes more acidic and thus the pH level decreases.

F) This disease causes increased level of acid in body which causes hyperventilation.This rapidly breathing reduces carbon dioxide in the blood to get rid of the body.

G) This occurs due to building of acidic substance in the body which causes fruity odour in the breathe.

H) High glucose level spills over into the urine which draws more water and solutes along with it and causes frequent urination..

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