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. A sudden, explosive, disorderly charge of neurons causes a transient aberration in brain function: This describes the pathophysiology of seizures, not myasthenia gravis.
B. Loss of the myelin sheath surrounding peripheral nerves causes asymmetric weakness: This describes multiple sclerosis, not myasthenia gravis.
C. Destruction of acetylcholine receptors causes muscle weakness with prolonged activity: Myasthenia gravis is an autoimmune disease where antibodies attack acetylcholine receptors at the neuromuscular junction, leading to muscle weakness, especially after repeated use.
D. A bacterial inflammatory illness that causes headache and photophobia: This describes meningitis, not myasthenia gravis.
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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