52 year old female with Diabetic ketoacidosis secondary to GE

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CBBLE UDHC similar cases

This is an online E log book to discuss our patient's de-identified health data shared after taking his/her/guardian's signed informed consent. Here we discuss our individual patient's problems through series of inputs from available global online community of experts with an aim to solve those patient's clinical problems with collective current best evidence based inputs. This E log book also reflects my patient-centered online learning portfolio and your valuable inputs on the comment box

 52 year old female who is a farmer came to the casuality with complaints of 

Shortness of breath since afternoon 

Vomitings since afternoon

Pain abdomen since afternoon

Dyspepsia since afternoon


HISTORY OF PRESENT ILLNESS :

Patient was apparently asymptomatic shortness of breath  since afternoon( grade 2 to grade 3 ) according to NYHA classification 

C/o vomitings ( 3 episodes food particle as content) , non bilious, non projectile 

C/o pain abdomen ( diffuse type) associated with loose stools  ( 2 episodes ) non blood typed , non foul smelling 

C/o dyspepsia since afternoon



PAST HISTORY : 

Similar complaints in the past ( was admitted in our hospital and treated 9 months back ) 

K/c/o DM  since 4 years on insulin (HAI -17 U -x-10U)

N/ k / c /o  HTN , Asthma , epilepsy , TB 



O/E :  

Patient is consious , coherent and cooperative

Bp:120/60mm hg 

PR ; 112 bpm  regular

RR :30 / min

Cvs : s1 s2 +

Rs : BAE +

P/A: soft , non tender 





PROVISIONAL DIAGNOSIS: 

Diabetic ketoacidosis secondary to GE 


Investigations : 


19/3/22

Urine for ketone bodies positive 


                    10pm     1 am     5 am

PH                6.94.      7.25      7.35

PCO2           9.2          19.9       27.8

PO2              125          87          72.9

HCO3            1.9          8.6         15

St HCO3        5.2         12.3        17.4


                   20/3/22     21/3/22

      


PH                7.36          7.36

PCO2            27.5          31.0

PO2              80.6           79.5

HCO3           15.2           17.2

St HCO3        17.5          19.2












21/3/22







TREATMENT: 

I. Inj HAI 6 U / IV /stat to Inj.HAI 40 IU in 39ml NS/IV/once 6 ml/hr

2.IVF - ns and rl @ 125 ml/ hr

3.inj pantop 40mg /IV /OD 

4.inj zofer 4mg/iv/od



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