35 year old male with DKA

 Hi, I am P.Ananya, a medical student . This is an E-Log, that depicts the patient centered approach for learning medicine .This E-Log has been created after taking consent from the patient and their relatives. The links that were used by me for understanding the available data on the particular disease have been mentioned below in each post . Hope you learn valuable information after giving it a good read!



CASE 


CHIEF COMPLAINT

Multiple bouts of vomiting and inability to hold down any water since episode of binge drinking. Patient also missed an Insulin dose on the night of drinking



HISTORY OF PRESENT ILLNESS 

Patient was asymptomatic 2 days ago

He had an episode of bimge drinking on the 5th of September after which he went home and slept

On that night he missed his dose of Insulin. 

On 6th September Patient could not hold down any liquid consumed and kept vomiting anything he consumed. 

He was taken to a private practice after which his blood sugar was measured and reported to be 600mg/dl.

He was given medication (insulin, antiemetic? ) and his vomiting episodes reduced

On the morning of 7th September he was brought to our ICU and has been undergoing treatment for Diabetic Ketoacidosis

He was diagnosed with Diabetes 2 years back on visiting a physician pertaining the complains of polydypsia and polyuria

Patient has made no lifestyle modifications following diagnosis. However takes medication regularly



HISTORY OF PAST ILLNESS 

Known case of diabetes since 2 years

No history of hypertension, asthma, Tuberculosis or seizures


DRUG HISTORY 

Patient has been taking a combination of metformin hydrochloride and Insulin 15U(BD) for type 1 diabetes mellitus. 


PERSONAL HISTORY 

Mixed normal appetite till before current episode of DKA

Normal bowel movement

Normal micturition

No known allergies

Chronic smoker. Patient doesn't recall when he started smoking. Currently smokes 2 to 3 cigarettes per day

Consumes Alcohol once in every 4 to 5 days. Approx 200 to 300ml



FAMILY HISTORY 

Father is known case if diabetes

No further significant history 



GENERAL EXAMINATION

Pallor absent

Icterus absent

Cyanosis absent

Koilonoichya absent

Lymphadenopathy absent

Edema absent




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