Cold n' Sweet DKA

BY S​AAD CHAUDHRY; CHI ZHANG; AHMED RAZ​IUDDIN, MD​​A 62-year-old tall, thin African American man presented to the emergency department after four days of constipation and vomiting. He had decreased mental status, and was unable to provide a complete medical background. His spouse reported that the patient had diffuse abdominal pain for the past four days, and had been experiencing increased thirst and excessive urination for the past four weeks.She reported that the patient was unresponsive to over-the-counter laxatives and had been unable to produce bowel movements. The patient had no prior abdominal surgery, medication use, or primary care visits. The patient used to be a 20-pack-a-year smoker, but he had quit smoking almost 10 years earlier. The patient also had shortness of breath for the past day but no fever, chills, or chest pain.Patient's vital signs had a blood pressure of 150/77 mm Hg, heart rate of 58 beats/minute, temperature of 98.1°F, and oxygen saturation of 99%. The patient later admitted to drinking two cans of beer a day and smoking marijuana habitually, but denied any family history of diabetes or hypertension.The patient appeared lethargic during the physical exam. He also had rapid deep breathing that required increased respiratory efforts. Vesicular breath sounds were heard bilaterally with the use of accessory muscles observed. The abdominal exam revealed a diffusely tender abdomen on palpation. There was no guarding, rebound tenderness, or or...
Source: The Case Files - Category: Emergency Medicine Tags: Blog Posts Source Type: research