Author Question: Identify any abnormal laboratory values measured upon her admission. Explain how they may be related ... (Read 93 times)

debasdf · **on:** Aug 21, 2018

Identify any abnormal laboratory values measured upon her admission. Explain how they may be related to her newly diagnosed T1DM.

What will be an ideal response?

Question 2

Assess Rachel's ht/age; wt/age; ht/wt; and BMI. What is her desirable weight?

What will be an ideal response?

sarajane1989 · **Reply #1 on:** Aug 21, 2018

Answer to Question 1

Chemistry Normal Value Rachel's Value Reason for Abnormality
Osmolality 285-295 mmol/kg/H2- 295.3 mmol/kg/H2- Slightly hyperosmolar due to hyperglycemia and resulting dehydration
Glucose 70-99 mg/dL 683 mg/dL Hyperglycemia due to insulin deficiency
Sodium 136-145 mEq/L 126 mEq/L Electrolyte imbalance due to hyperglycemia and resulting intracellular fluid shifts
Phosphate 2.2-4.6mg/dL 1.9 mg/dL Electrolyte imbalance due to hyperglycemia and resulting intracellular fluid shifts
HbA1C 3.9-5.2 14.6 Indicative of hyperglycemia over the previous 120 days
C-peptide 0.51-2.72 ng/mL 0.10 ng/mL Indicates that there is inadequate endogenous insulin synthesis
ICA --- + Presence of autoantibodies indicates autoimmune destruction of beta-cells
GADA --- + Presence of autoantibodies indicates autoimmune destruction of beta-cells
IA-2A --- + Presence of autoantibodies indicates autoimmune destruction of beta-cells
IAA --- + Presence of autoantibodies indicates autoimmune destruction of beta-cells
pH of urine 5-7 4.9 Acidic due to presence of ketones in urine
Protein, glucose, ketones in urine neg + All are present in urine due to the response to hyperglycemia; serum blood glucose of >180 mg/dL results in loss of glucose in the urine; protein and ketones are indicative of the increased rates of gluconeogenesis and lipolysis

Answer to Question 2

Age: 12 y/- Ht: 5' Wt: 82 BMI: 16 kg/m2
Height-for-age: between 50th and 75th percentiles
Weight-for-age: between 25th and 50th percentiles
BMI-for-age: between 10th and 25th percentiles
Healthy weight range 92-128 lbs. or 50tile BMI = BMI of 17.5-18 kg/m2