Chief Complaint: “itching all over” “tired” “weird taste in my mouth, everything

Question

Chief Complaint: “itching all over” “tired” “weird taste in my mouth, everything tastes gross” “my heart is racing” “swollen all over” “little short of breath” patient is noted to be scratching at his arms and abdomen while answering questions.

Labs: Na-146 WBC-14.3   

CL-104                   Hgb-14

BUN-28                  Hct-39

Cr-1.3                     Plt-312

K-5.1                       Glu-212

CO2-21

Urinalysis: Color-yellow

                                  Appearance-hazy

                                  PH-6.8

                                  Protein-2+

                                  Glucose-positive

                                  Ketones-large amount

                                  Bilirubin-positive

                                  WBC-large amount

                                  RBC-large amount

What would be some causes of his abnormal values? Are the values expected based on his chief complaint?

Explanation / Answer

Ans) The above mentioned abnormal values could be relted to kidney problems , Diabetes could be the cause of the lab testings and urinalysis as shown glucose positive , also presence of ketones in urine.

Proteinuria means protein traces in urine could also be possible sign of kidney related problems and specifically Diabetes and also High blood pressure. Serum bilirubin positive is also associated with Diabetes. There is also platelet dysfunction in Diabetes. Creatinine values can also be related to Diabetes.

Chief complaint of having itching on body could be related to condition called Diabetic polyneuropathy , in this condition the high blood glucose levels causes nerves to damage. People with diabetes can experience associated disorders including kidney or liver failure.

Electrolyte imbalance in the case provided shows relation with high blood glucose levels. As with high blood glucose or Diabetes body tends to flush out more electrolytes and other substances from body through urine and so imbalances of electrolytes is cause of Diabetes.

Abnormal values given above could be result of Kidney problems and Diabetes , as both Kidney disorders and Diabetes are related to each other. The values of urinalysis and other electrolyte and lab tests could be corelated to the chief complaints provided , as chief complaints shown are based on what the lab tests and urine analysis values shows about any Kidney related or basically Diabetes as there is presence of Ketones in urine and glucose levels high.

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