A 38 year old diabetic male presented to OPD with SOB and vomitings

 chief complaints

A 38 year old gentleman from Reddibavi came to the OP with the chief complaints - shortness of breath and vomitings.

History of present illness

The patient was apparently asymptomatic 3 days ago. 3 days back he had alcohol ( 2 quarters )

He missed his insulin shot 2 days back.

In the afternoon he had an episode of vomiting after lunch.

vomiting was non bilious, non foul smelling and no blood stains. It had food particles and watery in consistency.

SOB of grade 4 is seen.

History of past illness

Diabetic since 1 and half year- on insulin medication

No HTN/ TB/ Epilepsy 

Personal History

Mixed diet

Normal apetite

Regular bowel and bladder movements

Adequate sleep

Addictions- Alcoholic since 4-5 years

Beedi smoker of 5-6 per day since 4-5 years

General Examination 

 The patient is moderately built and nourished

He is conscious, coherent and cooperative and well oriented to time, place, and person.

NO pallor

NO icterus

NO cyanosis

NO Clubbing

No edema

NO lymphadenopathy 

Vitals

Temperature - 98.2'F

BP 100/60

RR 40

SPO2 95%

Investigations 

HIV non reactive

HCV Negative

Urine for KETONE BODIES - POSITIVE


HEMOGRAM



COMPLETE URINE ANALYSIS 


SERUM ELECTROLYTES



SERUM CREATININE
BLOOD UREA


LIVER FUNCTION TESTS

ABG ANALYSIS

- DIABETIC KETOACIDOSIS



TREATMENT 

IV fluids 1 NS 1RS , 5% DEXTROSE@100ML PER HOUR

INJ HAJ 1ml in 79ml NS infusion according sliding levels

INJ PAN 40mg/IV/OD/BBF



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