1. A 72-year-old woman is brought into the emergency suite with severe chest pai
ID: 3523121 • Letter: 1
Question
1. A 72-year-old woman is brought into the emergency suite with severe chest pain. Upon questioning by the admitting physician, she also reports a shortness of breath and dizziness. Her heart rate is 40 beats per minute. You order an EKG. Based on the limited information, what would you expect the EKG to show with respect to her heart activity? What condition would you diagnose this patient with and what is the likely cause of this condition? Suggest a possible treatment
2. While working as a scribe at a local hospital, you are witness to a 48-year-old male who arrived in the emergency suite who was unresponsive. Prior to becoming comatose, he reported to a friend he was experiencing mental confusion, nausea, abdominal pain and was breathing rapidly. Upon examination, he demonstrates he is breathing rapidly and has a blood pressure of 150/95. Lab tests show his blood glucose to be 450 mg/dL, he also has elevated serum potassium, magnesium and ketone levels. His blood pH is 7.28. Using your understanding of physiology, first attempt to diagnose this patient. Then explain each of the reported symptoms and clinical findings. You must account for all the reported symptoms and blood values for full credit.
Explanation / Answer
Answer 1
According to their heart activity I expect EKG reveals atrial fibrillation.
Conditions are irregular heartbeat certain Weakness which Reduced ability to exercise, Fatigue,Dizziness, having Shortness of breath & Chest pain
The goals for the treatment of this case are :
Answer 2
First we have to give fluid supplementations and extra insulin injections until ketones in the urine have either disappeared or fallen to low levels. during this period we should closely monitored Blood glucose and ketone levels
in the blood and urine High levels of ketones usually build up, causing the symptoms of DKA ( diabetic ketoacidosis ) abdominal pain, dry, cool skin,excessive thirst and urination, Fatigue,high blood glucose, nausea and vomiting,presence of ketones in the blood or urine ,rapid weight loss
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