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The lecture Hyperglycemic Hyperosmolar Syndrome (HHS) with Case by Michael Lazarus, MD is from the course Diabetes Mellitus. It contains the following chapters:
What accounts for the presence or absence of an anion gap in the following patient? An 80-year-old woman presents to the emergency department because of gradual progressive confusion and lethargy for the past 7 days. Her son reports that she had a bout of gastroenteritis with vomiting and diarrhea 3 days ago. Medical history: Type 2 DM and hypertension. She takes hydrochlorothiazide, metformin, aspirin, and a multivitamin. She is not compliant with her medication regimen. Physical examination results: dry oral mucous membranes, extremely lethargic but arousable, and has extreme difficulty following the conversation. Laboratory test results: Na: 126 mEq/L, Ca: 8.1 mg/dL, K: 3.9 mEq/L, glucose: 910 mg/dL, Cl: 94 mEq/L, traces of urine ketones, and bicarbonate: 25 mEq/L.
What is the mechanism of hyponatremia in the following patient? An 80-year-old woman presents to the emergency department because of gradual progressive confusion and lethargy for the past 7 days. Her son reports that she had a bout of gastroenteritis with vomiting and diarrhea 3 days ago. Medical history: Type 2 DM and hypertension. She takes hydrochlorothiazide, metformin, aspirin, and a multivitamin. She is not compliant with her medication regimen. Physical examination results: dry oral mucous membranes, extremely lethargic but arousable, and has extreme difficulty following the conversation. Laboratory test results: Na: 126 mEq/L, Ca: 8.1 mg/dL, K: 3.9 mEq/L, glucose: 910 mg/dL, Cl: 94 mEq/L, traces of urine ketones, and bicarbonate: 25 mEq/L.
What is the most likely diagnosis in the following case? An 80-year-old woman presents to the emergency department because of gradual progressive confusion and lethargy for the past 7 days. Her son reports that she had a bout of gastroenteritis with vomiting and diarrhea 3 days ago. Medical history: Type 2 DM and hypertension. She takes hydrochlorothiazide, metformin, aspirin, and a multivitamin. She is not compliant with her medication regimen. Physical examination results: dry oral mucous membranes, extremely lethargic but arousable, and has extreme difficulty following the conversation. Laboratory test results: Na: 126 mEq/L, Ca: 8.1 mg/dL, K: 3.9 mEq/L, glucose: 910 mg/dL, Cl: 94 mEq/L, traces of urine ketones, and bicarbonate: 25 mEq/L.
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