Question

Lab 10:"Case Study"- Multisystem approach A 5 year old, female, presents to the emergency room with LOC. Her parents state that she has always been an active child; however, recently she has become increasingly fatigued. They also state that she has been drinking a lot of water and going to the bathroom very frequently. Upon evaluation of the patient you notice that her breath has a fruity smell. 1.) What is the disorder? (Be specific) 2.) What area is dysfunctional? 3.) Why does the child present with fruity breath?

Answer 1

1) The child is suffering from Diabetic ketoacidosis.

Major symptoms of this disease are:

• Frequent urination
• High level of thirst
• Fruity-smelling breath
• Fatigue
• High blood sugar level
• Vomiting or nausea
• Abdominal pain
• A high concentration of ketones in the urine

2) This disease can be caused by:

• An infection/illness: The body produces more amount of hormones like adrenaline or cortisol. The effect of insulin is countered by these hormones. Thus the blood glucose level increases to a very high level.
• A problem in insulin therapy: Errors in insulin treatment can leave a very low amount of insulin in the body. This can also increase the blood glucose level
• Emotional or physical trauma
• Drug abuse
• Corticosteroid medications.

3) Due to the low concentration of insulin, more amount of glucose will be produced in the body. The liver also starts converting glucagon into glucose. It also starts to produce fatty acids. These fatty acids undergo beta-oxidation to release mildly acidic ketone bodies, as a result, the pH level of blood decreases. This produces a state called ketoacidosis. The body tries to buffer this situation by hyperventilation. During this stage, excess amount of CO2 is blown off. The enormous amount of ketones in the blood gives the fruity smell to the blown of air. Thus the breath of the patient has a fruity smell.