A patient with diabetes mellitus (DM) developed a serum glucose of 900 and an elevated serum osmolality. The patient then became unconscious. What pathological process most likely caused the altered neurologic status?
The brain cells became edematous because of a blood to tissue shift of fluid.
Hyperinsulinemia caused hypoglycemia and a tonic clonic seizure.
The brain cells became dehydrated because of fluid shirting out of the cells.
Fluid volume overload caused higher pressure in the brain tissue
The Correct Answer is C
A. The brain cells became edematous because of a blood to tissue shift of fluid: This describes cerebral edema, which is not typically caused by hyperglycemia.
B. Hyperinsulinemia caused hypoglycemia and a tonic-clonic seizure: The scenario describes hyperglycemia, not hypoglycemia.
C. The brain cells became dehydrated because of fluid shifting out of the cells:. In hyperglycemic hyperosmolar syndrome (HHS), extremely high blood glucose leads to increased serum osmolality, causing water to move out of brain cells, leading to dehydration and altered consciousness.
D. Fluid volume overload caused higher pressure in the brain tissue: Fluid volume overload is not the primary issue in this scenario; rather, dehydration is the concern due to hyperglycemia.
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Related Questions
Correct Answer is C
Explanation
A. Non-bloody diarrhea with abdominal cramps: These symptoms are not typical of pancreatitis. They are more common in gastrointestinal infections or irritable bowel syndrome.
B. Belching and burping within one hour after eating: These symptoms are usually associated with gastroesophageal reflux disease (GERD) or dyspepsia, not pancreatitis.
C. Severe epigastric pain that radiates to his back: Severe epigastric pain that radiates to the back is a hallmark symptom of acute pancreatitis.
D. Heartburn that worsens when lying down: This symptom is more characteristic of GERD rather than pancreatitis.
Correct Answer is A
Explanation
A. Status epilepticus: Status epilepticus is a life-threatening condition where seizure activity is continuous or occurs in rapid succession without recovery between seizures.
B. Anticonvulsant syndrome: This term is not a recognized medical condition.
C. Syphilitic posturing: This term is not associated with seizure disorders and is not a recognized condition.
D. Positive Babinski reflex: This indicates an upper motor neuron lesion but is not related to continuous seizure activity.
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