Second info Questions A 64 yo obese female with a 10 year history of NIDDM (non-

Question

Second info Questions A 64 yo obese female with a 10 year history of NIDDM (non-insulin dependent diabetes mellitus) presents to the clinic with chief complaint of "a sore on the top of my foot". The patient states that the "sore" has been present for 2 weeks and that she has been "watching and cleaning it." The last 3 days, she has noted that her foot is becoming somewhat "red and warm". She also reports malaise and some "blurriness in here vision. Presently, the patient is taking Metformin and has recently been placed on Humulin in the am because "her sugars were running high". She also takes Metoprolol for HTN. On examination, the BP is 142/94, temperature is 101 and a glucose reading is 326. There is a 2cm ulcer on the dorsal medial aspect of the L foot at the medial cuneiform with some "greenish discoloration". There is no other "drainage" from the area. The foot overall is mildly edematous with erythema (redness) of the skin surrounding the ulcer and extending over the dorsum of the foot. She is admitted to the hospital with a diagnosis of cellulitis of the L foot secondary to ulcer formation.

Explanation / Answer

Question 7) Secondary to the infection the patient becomes unconcious,and goes into coma. This is because of HHNS - Hyperglycemic Hyperosmolar non Ketonic Syndrome. This leads to the serious complications.

8) The bacterial strain most likely to cause these symptoms is Staphylococcus.

9) The tiny red lesions are called Necrobiosis Lipoidica Diabeticorum. (NLD). This starts as dull red raised areas . It may be itchy and painful.

10) The leisons are caused due to Pancreatic Beta cell Dysfunction.

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