70 year female with DKA
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70 year old female with complaints of 1) h/o sob and vomitings 3days back
2) involuntary movements since 4 clock yesterday
Hopi:-
Patient was apparently assymptomatic 3days back then she developed sob on lying position&
1 episode of vomiting 3days back which was relieved. She started experiencing sudden involuntary movements of the body at around 4 to 5' o clock. She was conscious but her speech was incoherent.
Pt was taken to the nearby govt hospital and symptomatic treatment was given after which she was referred to a higher centre i.e. our hospital for seeking treatment.
Past history :-
Known case of DM
Not a k/c/o htn, tb, astma, cva, cad
H/o thorn prick to the plantar aspect of foot 25 years back for which proper care was not given .
Examination
Pt was conscious, partly coherent and not well oriented to time place and person
No pallor, icterus, cyanosis, clubbing, pedal edema
VITALS:-
Temp :-98.6F
Pr:-76bpm
Bp:-130/80
RR:-26cpm
Grbs :-342mg/dl
SYSTEMIC EXAMINATION:-
Cvs:- s1, s2+
Cns:- NAD
P/A:-SOFT non tender
R/s:- BAE+
Left foot
DIAGNOSIS :-
DKA WITH SEIZURES
INVESTIGATIONS:-
TREATMENT:-
1)INJ HAI 40U IN 39 ML NS IV@6ML/HR
2) IV FLUIDS NS/RL, 10D @ URINE OUTPUT+ 50ML/HR
3) INJ. OPTINEURON 1amp /in 100 ml NS /IV/OD
4) INJ LORAZ 2 CC/IV/ SOS
5) PROTEIN X POWDER 1SCOOP IN 100ml milk 8th hrly
6) INJ 25% DEXTROSE 100ML /IV /SOS
