Pathophysiology Clinical Vignette Question
A 6-year-old boy is admitted to the emergency department with nausea, vomiting, and abdominal pain. He is very lethargic; his skin is warm, dry, and flushed; his pulse is rapid, and he has a sweet smell to his breath. His parents relate that he has been very thirsty during the past few weeks, his appetite has been poor, and he has been urinating frequently. His initial plasma glucose is 420mg/dL, and a urine test for ketones is strongly positive.
- What is the most likely cause of this boy’s elevated blood glucose and ketonuria? I'm guessing that he has hyperglycemia and diabetic ketoacidosis. Is this correct?
- Explain his presenting signs and symptoms in terms of the elevated blood glucose and metabolic acidosis.