Q.4. A 45-year-old man was hospitalized with complain of dizziness and weak-
ness. His random blood sugar was 40 mg. History revealed that he had the
skipped breakfast. What is the probable diagnosis?
Ans: Patient has hypoglycemia, probably due to fasting. Under physiological
conditions, brain derives energy from glucose. Hypoglycemia is considered
when blood glucose levels fall below 60 mg/dl, and symptoms begin at this
concentration of glucose. The brain symptoms appear when glucose level
falls below 50 mg/dl.
39.2 Case Studies of Diabetic Ketoacidosis..................
Q1. A 45-year-old male was admitted to hospital in an unconscious state. He
appeared moderately dehydrated with increased pulse rate and acetonemic
breath. The urine analysis report showed presence of high amount of sugar,
and Rothera’s test was positive for ketone bodies. What is the probable
diagnosis?
Ans: Excretion of sugar in urine is accompanied by polyuria, which therefore
causes dehydration. This is a case of diabetic ketoacidosis. High levels of
ketone bodies in blood cause acetonemic breath and unconsciousness.
Q.2. A patient was admitted in the hospital in unconscious state. His blood
glucose level was 290 mg/dl. His urine was positive for both Rothera’s
test and Benedict’s test.
What is the diagnosis?
Ans: High blood glucose levels and presence of ketone bodies in urine indicate
diabetic ketoacidosis which is a life-threatening complication arising due to
diabetes mellitus. Ketone bodies in urine occur due to insulin deficiency and
less utilization of glucose by cells.
Q.3. A young boy was admitted to hospital in a delirious state. The examination
showed that he was breathing rapidly and appeared dehydrated. Laboratory
investigation results showed high blood sugar levels (325 mg/dl) and high
serum K+(6.5 mEq/L) levels, but serum sodium was normal. Urine test was
positive both for ketone bodies and reducing sugars. Give comment on
diagnosis.
Ans: Increased blood glucose value with presence of sugar and ketone bodies in
urine is indicative of diabetic mellitus. Hyperkalemia is seen in insulin
deficiency as K+uptake by cells requires insulin.
Q.4. A known diabetic patient was admitted to hospital in a semiconscious state.
He had cellulitis on the right foot. The laboratory investigation on blood
sample showed:
158 39 Some Important Case Studies