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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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. The patient is now sleepy and won't wake up: Increased drowsiness or difficulty waking up could indicate worsening of the hemorrhagic stroke, potentially due to increased intracranial pressure or a secondary brain injury.
B. Identification of an elevated serum cholesterol level: Elevated cholesterol is a risk factor for ischemic strokes but is not a direct indicator of complications from a hemorrhagic stroke.
C. The presence of nausea and a headache: This could be a common symptom following a hemorrhagic stroke but is not necessarily a specific indicator of a complication.
D. A complaint of neck pain and light intolerance: These symptoms are less specific to complications of a hemorrhagic stroke and could be related to other issues.
Correct Answer is B
Explanation
A. Decreased respirations and CO2 retention: A thyrotoxic crisis (thyroid storm) typically involves increased, not decreased, respiratory rates and CO2 retention due to increased metabolic activity.
B. Seizures and extreme tachycardia: Thyrotoxic crisis is characterized by severe symptoms including extreme tachycardia, fever, and potentially seizures due to excessive thyroid hormone levels.
C. Constipation and a swollen abdomen: Constipation and abdominal swelling are more typical of hypothyroidism rather than a thyrotoxic crisis.
D. Hypotension and bradycardia: Thyrotoxic crisis usually causes tachycardia and hypertension rather than bradycardia and hypotension.
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