Critical Thinking Question (5 pts.) (You may use the back of the page to write y

Question

Critical Thinking Question (5 pts.) (You may use the back of the page to write your answer if needed). Today's question has 2 parts. Use what you have learned in the lecture on Endocrine system to answer both parts: Kyle has been diagnosed with Diabetes Mellitus type I when he was 12 years old. Today, Kyle is a 23 year old drummer in a rock band. He partied hard last night, and today he missed the band rehearsal. So his bandmates came to his apartment to check up on him and found Kyle unresponsive in bed. There was a strong smell of acetone in the room. They called an ambulance and Kyle was transported to a hospital. Upon assessment, Kyle's glucose was found to be in the higth was dehydrated, and diagnosed with Diabetic Ketoacidosis. In addition, there was a nasty abscess found on h an old spider bite that happened a month ago Kyle was given lots of IV fluids, which helped. 1. is back from Explain what is going on with Kyle now? How did he end up with DKA? Why the old spider bite did not heal and turned into an infection? a. b. Why was he given IV fluids? And how did that help? c. 3 years later, Kyle has his diabetes under control. He is traveling today from San Francisco to New York, but due to a bad weather, his flight was delayed. Now that the plane is finally in the air, Kyle started acting strange, nervous and anxious. The flight attendant noticed that Kyle was shaking and sweaty. She offered him some 7UP. When Kyle had the beverage, he felt better 2. Explain, what happened in this case: why did Kyle act strange and was shaking and sweating. Why drinking the 7UP helped? a. b.

Explanation / Answer

1) a) Kyle having been diagnosed with Diabetes mellitus type 1 11years back which is due to immune mediated destruction of islet cells of pancreas which is prone to ketoacidosis and require insulin from the beginning of the therapy .

DKA is precipitated by : Infection , non adherence to medication and alcohol intoxication . Kyle has a history of spider bite one month back which might have got infected or he might have not been taking his medications regularly .

Anything that increases cortisol output as a stress hormone can lead to DKA because cortisol makes the peripheral tissues insensitive to insulin and drives up the glucose level. If the cells cannot take in glucose as a fuel, then the cells
seek an alternate fuel such as ketoacids.
DKA presents with a profoundly ill person rangingfrom mild confusion to coma. Patients are hyperventilating because of the compensatory response to metabolic acidosis.

b) Kyle blood sugar level was very high which provided a good culture media for the growth of bacteria . Also , due to long standing diabetes mellitus he might have developed peripheral neuropathy which leads to loss of sensation and hence he might have not noticed the pain .

c) The best initial therapy for DKA is high-volume fluids (normal saline) and intravenous insulin.

When the acidosis is severe, the serum potassium level will be elevated.This will lead to urinary loss of potassium. Hence, the blood potassium level will be elevated, but the body will be depleted of potassium. As the acidosis is corrected, potassium will move back into the cells and hypokalemia may develop.

2) a) Diabetes mellitus patient have 3 symptoms : polyuria , polydipsia and polyphagia . Since , his flight was delayed , Kyle developed stress . Stress increases cortisol output as a stress hormone , cortisol makes the peripheral tissue insensitive to insulin and drives up the glucose level which causes sweating and nervousness.

b) 7UP improves the body fluid volume .

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