In: Anatomy and Physiology
Endocrine System disorder
Case: 15 year-old Zinga is brought to the ER by her mother. She is hyperventilating, vomiting and complaining of nausea. Her mother states that her daughter has not seemed like herself lately.
She is very thin (and recently has been losing weight) although her mother indicates she has been eating and drinking continuously.
Her urinary frequency has increased dramatically. She has even been having trouble with bed-wetting although this previously had not been a problem.
What disease do you suspect Zinga could be suffering from?
As a doctor laboratory tests would you perform to confirm your suspicions?
How can you explain Zinga’s nausea and hyperventilation?
How would you describe Zinga’s breath and urine? What would cause them to be this way?
What treatment would you recommend for Zinga?
What disease do you suspect Zinga could be suffering from?
Answer: She is suffering from diabetes mellitus. She is showing characteristic symptoms of the diabetes:
- Polyphagia ( Excessive eating0
- Polydipsia ( Increased drinking due to increased thirst0
- Polyuria ( Excessive urination)
Hyperventilation is the symptom presenting in the diabetes ketoacidosis due to low blood pH.
As a doctor laboratory tests would you perform to confirm your suspicions?
Answer: Teset needs to be done are:
- Oral glucose tolerance test
- fasting blood glucose
- Random blood sugar
- HbA1c estimation
- Plasma Insulin and glucagon
- Urine analysis
How can you explain Zinga’s nausea and hyperventilation?
- Nausea and hyperventilation is due to the low blood pH due to higher level of ketone acids in the blood. High glucose in the diabetes is diverted to the formation of ketone bodies.
How would you describe Zinga’s breath and urine? What would cause them to be this way?
Explanation: Her breath would be deep and rapid ( kussmaul breathing) rich in CO2 and her urine will be acidic with glycosuria ( glucose in urine) and ketone bodies.
What treatment would you recommend for Zinga?
explanation: Most commonly in juvenile age, the cause of diabetes is damage of insulin producing beta cells of the islets of Langerhans would be adviced.
Acidosis can be treated by giving sodium bicarbonate.
hypotonic saline is given to diabetic ketoacidosis patient.