HSS 121 Individual Project 5

Medical Case Study with New words and Definitions

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Michelle Stahl9/17/2011

Michelle Stahl HSS 121 Medical Cast Study IP 5

Medical Case Study

A female patient aged 25 years came into the ER barely conscious by Paramedics via

ambulance. Patient complains of excessive emesis, polyuria, polydipsia, diplopia, cephalalgia,

acidosis, and fatigue for the past two days. Emergency room M.D. suspects diabetic

ketoacidosis. Patient denies a history of diabetes mellitus. Patient also complains of rapid

weight loss in the past month of 15 pounds, despite eating all of the time. Patient has noticed a

strange order when bathing, and profuse diaphoresis.

The patient has not had past medical history showing a diagnosis of diabetes. She does

indicate a history of migraines, depression, and frequent UTI. Past surgeries include an

appendectomy in March 1998 and a tonsillectomy in 1985. There have been no recent

hospitalizations on record. Physical examination reveals a BP of 145/80, WT of 115 lbs., HT of

5’6”, HR slightly tachycardia 112 beats per minute, temperature of 99 degrees. Medications

include Topamax 50mg for migraines and Cymbalta 200mg for Depression, fish oil

supplementation for health maintenance, daily vitamin, and powdered cranberry to treat recurrent

UTI infection.

Physician ordered a pregnancy test, CBC with differential, urinalysis with checks for

glycosuria, ketones, creatine, micro albumin, and electrolytes, as well as specific gravity, sent

a vial of blood for analysis of BG due to inability of glucometer not giving a clear reading, and

displaying “High”. The blood will also need to be tested for insulin and C-Peptide, to determine

if the pancreas is still producing insulin or displaying insulin resistance. Patient was started on

normal saline solution through an IV and given 10 units of insulin by IV to bring down blood

sugar. Blood is also to be tested for infection to determine if antibiotics need to be administered.

Michelle Stahl HSS 121 Medical Cast Study IP 5

The lab will take hourly blood glucose readings until blood sugars are within a normal range of

100 to 130 md/dl. Potassium will be given as needed to correct electrolyte imbalance of the

blood due to excessive emesis. Fluids will need to be given by IV to rehydrate and flush ketone

bodies from the blood to correct acidosis.

Tests show elevated ketones, negative pregnancy, and elevated white blood cells

indicating an infection. Urinalysis indicated possible bladder infection, hyperglycemia, and

advanced dehydration. Antibiotics were ordered to treat cystitis infection, insulin drip to correct

blood sugars, electrolytes via IV to correct dehydration and correct acidosis. The patient was

admitted to the hospital for observation and diabetes education in the endocrinology

Department. Patient will not be released until blood sugars are brought under control and patient

has demonstrated an ability for self-care by administering insulin via injections. Patient’s

diagnosis is diabetic ketoacidosis, hyperglycemia, and cystitis infection.

Patient is to be discharged with a follow up to an endocrinologist and certified diabetes

educator within two weeks. A follow up with the patient’s primary care doctor will be within

one week. Two weeks of an oral antibiotic to be taken BID at home, and a prescription for

insulin, needles, test strips and a blood glucometer for home use. Patient was in the hospital for

seven days. Patient is to test blood glucose and record results with meals and postprandial.

Patient is to take Lantus insulin in the AM of 10 units, and a bolus of Humalog of 1 unit for

every 15 carbohydrates with meals. Patient can take a correction factor of 1 unit for every

30mg/dl of blood sugar over 120mg/dl. Patient is to return to ED immediately if vomiting, or

elevated blood sugars of over 350mg/dl recur.

Part 1 New words

Michelle Stahl HSS 121 Medical Cast Study IP 5

Urination urin/o- urine (word root) –ation process (suffix). The process of expelling

urine from the body.

Cephalic cephal/o- the head (word root), -ic pertaining to (suffix) pertaining to the head.

Cardiac cardi/o- the heart (word root), -ac pertaining to (suffix)

Appendicitis append/o- appendix (word root) -ic pertaining to (suffix), -itis

inflammation or infection. Inflammation or infection pertaining to the appendix.

Tonsillitis tonsil/o (word root) tonsil, -itis (suffix) inflammation Inflammation or

infection of the tonsils.

Hypoglycemia hypo- (prefix) below or less than, glyc/o (glucose or sugar), -emia

pertaining to the blood. Below or less than normal blood sugar.

Biology Bi/o- (word root) living cells or organism, -logy (suffix) study of. The study of

living organisms.

Diabetic diabet/o Nueropathy - diabet/o (word root) diabetes, (suffix) –ic pertaining to.

Neur/o- (word root) nerve, -pathy (suffix) disease condition. Pertaining to a disease of the

nerves caused by diabetes.

Ketogenesis ket/o- (word root) ketone a molecule of fat oxidation, -genesis (suffix)

creation or production of. The creation or production of ketones as a byproduct of fat oxidation.

Optic- Opt/o (word root) vision or eye, -ic (suffix) pertaining to. Pertaining to vision.

Michelle Stahl HSS 121 Medical Cast Study IP 5

Part 2 Definitions

Emesis the reflex action of ejecting the contents of the stomach through the mouth.

(Bantam, 2009)

” The patient could not keep solid food down due to vomiting.”

Diabetic Ketoacidosis a metabolic state resulting from a profound lack of insulin,

usually found in type 1 diabetes mellitus, inability to inhibit glucose production from the liver

resulting in hyperglycemia which can be extreme and lead to dehydration. The conversion of fat

to glucose creates ketones and metabolic acidosis which can be extreme. (Bantam, 2009)

“The doctor suspected diabetic ketoacidosis upon smelling the patient’s breath and

extreme thirst.”

Diabetes Mellitus a disorder of carbohydrate metabolism in which sugars in the body are

not oxidized to produce energy due to lack of pancreatic hormone insulin or to resistance to

insulin. The accumulation of sugar leads to its appearance in the blood, and urine. (Bantam,

2009)

“The patient was diagnosed with Diabetes Mellitus when his fasting blood sugar came

back over 250 mg/dl.”

Migraines a neurovascular disorder in which instability within the brainstem is triggered

by various stimuli and usually leads to a throbbing headache that characteristically affects one

side of the head. (Bantam, 2009)

“I use suppression therapy for my migraines to avoid taking narcotics for the pain.”

Michelle Stahl HSS 121 Medical Cast Study IP 5

Postprandial occurring after eating. (Bantam, 2009) post- after, prand/o- by mouth, -al

pertaining to.

“The medication directions indicate that this pill is to be taken postprandial, twice a day.”

Part 3

CBC with differential complete blood count a broad spectrum test to screen for anemia,

and infection as well as many other diseases. (Bantam, 2011)

BG blood glucose (Turley, 2011)

IV Intravenous. (Turley, 2011)

M.D. medical doctor (Turley, 2011)

ER emergency room (Turley, 2011)

BID means twice a day

Michelle Stahl HSS 121 Medical Cast Study IP 5

References

Market House Books, LTD. (2009). The Bantam Medical Dictionary (sixth edition) New York, NY; Bantam Dell a division of Random House, Inc.

Turley Susanne M. (2011) Medical Language: Immerse Yourself. Upper Saddle River, NJ.

Pearson.