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Case Study 53 - Diabetes Mellitus, Type1

James Moore
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1) “Some people I know with diabetes can take pills,” says S.C. “Why can’t I take pills
instead of having to take insulin?” she asks. What is an appropriate response to her

2) What is the single greatest risk factor for type 1 diabetes mellitus that this patient

3) What causes heavy breathing in a patient with type 1 diabetes mellitus?

4) What is this type of breathing called?

5) Why is it appropriate for the physician to inquire about fever, chills, diarrhea,
cough, sore throat, and painful urination?

6) Distinguish between paresthesias, dysesthesias, and anesthesias.

7) Describe the pathophysiology of paresthesias, dysesthesias, anesthesias.

8) Which types of endocrine disorders are characterized by heat and cold intolerance?

9) Is this patient technically underwieght, overwigth, obese, or is the patient’s weight
healthy and normal?

10) Identify three signs that suggest this patient is dehydrated.

11) Are “downgoing plantars” a normal or abnormal neurologic response?

12) Identify four laboratory test results that are consistent with a diagnosis of diabetic

13) How was anion gap determined in this patient?

14) Identify three laboratory test results that are consistent with a diagnosis of

15) What has probably caused this patient’s abnormal plasma sodium and chloride

16) Why is this patient’s serum potassium concentration abnormal?

17) Why is this patient’s blood pH abnormal?

18) Explain the pathophysiology of this patient’s low PaCO2

19) What is the single major precipitating factor for this patient’s ketoacidosis?

20) Provide seven clinical manifestations for your answer to question 19 above.

21) How is ketoacidosis most effectively managed?


Case Study 53 - Diabetes Mellitus, Type1

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