Case Presentation. A 48 year old lady presenting with DKA Karuna Spiegelman, M.D. August 9, 2006. History of present illness.
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A 48 year old lady presenting with DKA
Karuna Spiegelman, M.D.
August 9, 2006
Pat B is a 48 year old Type I diabetic who was transferred from Darlington ER, where she presented with 3 days of nausea, vomiting and intermittent chills. In the ER, she was found to have a blood sugar of 980, pH 6.96, pCO2 11.2, bicarbonate of 2.5. She was placed on an insulin drip and transferred to Meriter Hospital.
Most of the history is obtained from the patient’s husband as the patient is unable to provide us with any information as she is obtunded.
The patient’s blood sugars have recently been in the 400s, despite her taking insulin and other medications as she usually does. She was drinking a lot of water, but did not complain of chest pain, shortness of breath, cough, sputum production, abdominal pain, diarrhea.
Pat is married and the mother of 2 grown up children. She works as a registered nurse at a clinic in Darlington, WI. No history of tobacco or alcohol or illicit drug use.
Both parents died of cancer of unknown primary. Siblings and children healthy
So, what is so interesting in a patient with DKA?????
So, what happened to Pat……
Day # 3 (after we obtained the MRI) she woke up
Rheumatology - vasculitis?
Neurology - rapid and remarkable recovery
Neurosurgery - stenting v/s bypass
She continues to follow with her neurologist locally …..