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. Moon face, buffalo hump, and hyperglycemia: These manifestations are associated with Cushing's disease, not Addison's disease.
B. Hirsutism, fever, and irritability: These symptoms are not characteristic of Addison's disease.
C. Anorexia, fatigue, and hypotension: Addison's disease often presents with symptoms like anorexia, fatigue, hypotension, and hyperpigmentation of the skin.
D. Tachycardia, exophthalmos, and goiter: These symptoms are associated with hyperthyroidism, not Addison's disease.
Correct Answer is D
Explanation
A. Low T4, High TSH: This pattern is seen in primary hypothyroidism, where the thyroid gland is underactive.
B. Low T4, high calcitonin: This choice is unrelated to the typical lab findings in Graves' disease. Calcitonin levels are not commonly assessed in thyroid disorders like Graves' disease.
C. High PSA and estrogen levels: PSA (Prostate-Specific Antigen) and estrogen levels are unrelated to Graves' disease, which is an autoimmune hyperthyroid condition.
D. High T4, low TSH: Graves' disease is characterized by hyperthyroidism, where T4 (thyroxine) levels are elevated, and TSH (Thyroid-Stimulating Hormone) levels are suppressed due to the negative feedback mechanism.
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