Treated with basic-bolus insulin therapy

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Reference no: EM133993764

Question

A girl 18 years, suffers from diabetes for 5 years. She is treated with basic-bolus insulin therapy - 36 units of insulin/day. During pneumonia condition sharply deteriorated - increased thirst, abdominal pain, nausea, vomiting, drowsiness. The patient refused the food has not received an injection of insulin, and in the morning lost consciousness. Objectively: patient is unconscious. The skin is dry, turgor reduced. Tongue dry. Breathing noisy, deep, smell of acetone. Body temperature - 36,6 ?C, pulse - 100/min, BP - 90/50 mm Hg. In urine positive reaction to acetone. Glycemia - 33 mmol/l. What preliminary diagnosis? 1. Diabetic ketoacidosis 2. Hyperosmolar coma 3. lactic acidosis 4. Hepatic coma 5. Cerebral coma.

Reference no: EM133993764

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