8-year-old girl with excessive thirst, frequent urination, and weight loss. Cind

Question

8-year-old girl with excessive thirst, frequent urination, and weight loss. Cindy Mallon. 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 glassfulls 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. 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 (normal = 7.35 - 7.45) urine = tested positive for glucose and for acetone/acetoacetate (i.e. ketone bodies) (normally urine is free of glucose and ketone bodies) A. Why is her blood-glucose level elevated? B. Why is her blood pH level decreased? C. At the office. Cindy is breathing rapidly and taking deep breaths. What physiological purpose does this serve? D. Cindy has a fruity odor to her breath. Why? Explain why this is occurring. E. Explain why Cindy is urinating so frequently. F. How is Cindys condition like that of starvation? Address the role of glucagon in your answer. G. How do you think the pediatrician is going to treat Cindy's condition? Are there any risks or potential complications to her treatment?

Explanation / Answer

ans-A-as condy's blood glucose report showing the high glucose level i.e. 545mg/dl it means cindy has Type I or insulin dependent diabetes mellitus and Her pancreas is not making a sufficient amount of the hormone insulin.The function of insulin is to control the blood glucose level by stimulating the uptake of blood glucose into skeletal muscle and insulin secreted from the pancreas gland.Symptoms of diabetes mellitus

ans-B -as cindy's report shows that Low pH i.e. 7.23 and glucose and acetone/ acetoacetate (i.e. ketone bodies) both are test positive.Due to the elevated glucagon's effects the hormone glucagon stimulates fat breakdown or lipolysis and the release of lipids from adipose tissue into the blood.The increased glucogon's effect and the decreased insulin activity cause elevated blood lipid levels which rise the ketone bodies in the blood ,the pH of the blood falls. This condition is called diabetic ketoacidosis.

ans-c-Due to the diabetic ketoacidosis the patients body's attempt to blow off as much carbon dioxide in a form of hyperventilation this condition is called the Kussmaul's respirations.

ANS-D-Due to the Presence of ketone body acetone has a fruity odor.Cindy's blood acetone level is increased and this acetone moves through the blood into the alveoler sac of the lungs which cause the fruity odor.

Ans-E-Glucose is normally filtered out of urine by the kidneys. It is only present if there is high glucose in the blood that not all can be filtered or the kidneys are not functioning properly and it is the main symptoms of diabetic ketoacidosis or diabetes mellitus.This condition, known as osmotic diuresis in which kidney's active transport pumps work not properly, this cause the dehydratation.

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