Question

Case Study #4 Al was brought to the emergency room by his landlady, who stated that he had been drinking heavily for the past week. During this time his appetite had gradually diminished, and he had not eaten any food for the past 3 days. Upon physical examination, he was confused, combative, tremulous, and sweating profusely. He speech was slurred. Vital signs: HR - 110 bpm, was unknown at the time of the examination. While waiting for further laboratory results, Al hada violent diffuse repetitive contractions of body for approximately 5 minutes. Laboratory results came back are listed below. Blood glucose level - 28 mg/du before the patient had the episode, blood ethanol - 298 mg/d. 1. What is the diagnosis of this patient? 2. What did Al use for energy leading up to this emergency room visit? Explain why Al's blood glucose level was 28 mg/dL. 3. When Al's blood glucose level became 28 mg/dL, what other biochemical reactions also occur? 4. Al's blood lactate level was 7.2 mM or 65 mg/dL, blood pH of 7.14 which is indicative of lactic acidosis. Why did Al have lactic acidosis? (Reference range: lactate level 0.6-2.2 mM/5.4-19.8 mg/dL; blood pH 7.36-7.45) 5. Individuals with a Glucose 6-phosphatase deficiency of often develop a lactic acidosis during fasting. Explain why this occurs.

Answer 1

Answer :

1) based on above case study ,the person is on hypoglycemic shock .

Hypoglycemic shock : it is a life threatening condition when the blood sugar levels lower than 70 mg / dl.

Hypoglycemia is a condition in which the blood sugar levels badly come down than normal range .

Normal range of blood sugar is 120 mg / dl .

2) he is taken alcohol very badly and the range about 298 mg / dl .

Ethanol inhibit the gluconeogenesis ,it typically followed by several day alcohol binge .

The blood alcohol levels normally between 20 to 50 is may not cause any danger to him but he is taken alcohol heavily,it adversely lower the blood glucose levels and he is not taken food since 3 days ,so he had the hypoglycemic shock with the symptoms of confusion, slurred speach , tremors , contractions and sweating etc .

And Sweating also one factor to decrease his blood glucose levels .

3) epinephrine increases to compensate with low blood sugars .

Glucogon also also releaed to maintain blood glucose levels .

In hypoglycemia ,the blood pressure may fall down ,pulse may increases .

4) if the person is consumes binge alcohol it can increase the lactate level in blood .

High lactate level causes low ph in body .

Another thing is ,he is not taken food since 3 days ,the person need energy so the carbohydrates breakdown releases lactic acid ,so he is having lactic acidosis