Patient 1 - The parents of an 11 year old girl bring her for an office visit. She has been
developing normally and has been healthy and active. Her parents report that for the
past several weeks, she has been feeling tired and weak, drinking more fluids than
normal, and has been urinating so much she has wet the bed at night. Two days ago,
they noticed that her breath smelled "like fruit" and she lost 8 pounds these last weeks.
Yesterday she began breathing fast and deep.
a. Present your initial diagnosis. I don't feel like I can make a concrete diagnosis with
just the symptoms at hand, however, due to the presentation of symptoms
demonstrated by this 11-year-old girl, we need to rule out the possibility of Diabetic
ketoacidosis. The clinical symptoms for this assumption include: "fruit-like breath",
increased thirst, bed wetting that is unusual for child, and breathing fast and deep. Thes
symptoms are accompanied with the child feeling weak and tired with a significant
amount of weight loss. All symptoms are text-book signs of Diabetic keto-acidosis
(McCance et al., 2018)
b. Describe the pathophysiologic explanation(s) to support your diagnosis and the
clinical symptoms presented. Insulin is needed to push glucose into the cells. When
there is a lack of insulin, glucose builds up in the blood stream.
c. List the test(s) you would perform to confirm your diagnosis, the rationale for each te
ordered, and the results you would expect if your diagnosis is correct.
d. Describe your recommended treatment(s) and the rationale to support your
recommendation(s).