General

CaseStudy-06112016-2

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6 Nov 2016 - General
 

An elderly lady, nursing home resident, with background of advanced dementia, previous stroke, ischaemic heart disease, hypertension, type 2 diabetes mellitus, and recuurent urinary tract infection, was admitted to hospital due to reduced oral intake for 1 week, with few episodes of pyrexia for the last 2 days, became increasing confuse and agitation. Patient was confused on admission, with low grade pyrexia, with hypotension of blood pressure around 80/60. Blood tests showed elevated white cell count, neutrophil, and CRP. ECG and chest x ray were normal. Urine dipstick showed likely urinary tract infection. Urine and blood culture & sensitivity was sent. What is your diagnosis (patient was hypotensive) for this patient ?? What will be your management and treatment plan ??

DKA is an extreme decompensated diabetes mellitus with a hallmark feature of the triad of hyperglycemia, ketosis and anion-gap metabolic acidosis. Polyuria, polydipsia, nausea, vomiting, abdominal pain, mental status changes, Kussmauls respiration and acetone breath are some clinical manifestations of patients suffering from this medical emergency. Random glucose test, ABG, serume and urine ketones, serum electrolytes, BUN and creatinine are some laboratory tests that need to be requested in ord...
 (Total 96 words)
An elderly lady with diabetes mellitus is prone to depelop diabetic ketoacidosis and an infection may be a triggering factor.
I think this is a case of Diabetic Ketoacidosis (DKA) with Urinary tract infection. An urgent RBS will help to confirm the diagnosis.
Hyperglycemic Hyperosmolar State(HHS) and Uremia are two differential diagnoses.
Immediate resuscitation is required with intravenous fluid, antibiotics and Insulin . Blood sugar level need to be controlled. Blood sample shoul...
 (Total 99 words)
An elderly people with diabetes mellitus is prone to depelop diabetic ketoacidosis and an infection may be a triggering factor.
I think this is a case of Diabetic Ketoacidosis (DKA) with Urinary tract infection. An urgent RBS will help to confirm the diagnosis.
Hyperglycemic Hyperosmolar State(HHS) and Uremia are two differential diagnoses.
Immediate resuscitation is required with intravenous fluid, antibiotics and Insulin . Blood sugar level need to be controlled. Blood sample sho...
 (Total 99 words)