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 D
Explanation
A. Obesity, age over 40, and female gender: While obesity and age can be risk factors for GERD, gender alone is not a significant factor. Excessive alcohol consumption, as indicated in option D, is a stronger link to GERD.
B. Accelerated gastric emptying: This is incorrect. GERD is more commonly associated with delayed gastric emptying or increased acid production rather than accelerated gastric emptying.
C. Incompetent rectal sphincter: This is incorrect. GERD is associated with an incompetent lower esophageal sphincter, not the rectal sphincter.
D. Drinking 12 cans of beer per day: Excessive alcohol consumption can relax the lower esophageal sphincter and increase the risk of GERD by allowing stomach acid to flow back into the esophagus.
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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