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. Hemiparesis of the left arm and leg with nystagmus: A left hemispheric stroke typically affects the right side of the body.
B. Eyelid and mouth drooping on the ipsilateral side: Facial drooping due to a stroke typically occurs on the contralateral side of the body.
C. Homonymous hemianopia of the left visual field of both eyes: A left hemispheric stroke typically causes right-sided homonymous hemianopia.
D. Hemiparesis of the right arm and leg with aphasia: A left hemispheric stroke often results in right-sided hemiparesis and can affect language centers, leading to aphasia.
Correct Answer is A
Explanation
A. Decrease osteoclastic activity: Osteoporosis treatments often focus on reducing osteoclastic activity, which is responsible for bone resorption, thereby helping to maintain or increase bone density.
B. Increase the kidneys' tubular secretion of calcium into the urine: This would decrease calcium levels in the body, which is not desired in osteoporosis treatment, as it would worsen bone density.
C. Increase resorption of calcium: Increasing bone resorption would exacerbate osteoporosis by weakening the bones further.
D. Suppress calcitonin: Calcitonin helps to inhibit bone resorption, so suppressing it would be counterproductive in treating osteoporosis.
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