sanz
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D.
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| ELM
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Why not E???
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| sanz
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Type 2 DM are more prone to hyperosmolar non-ketotic coma due to hyperglycaemia, esp in the elderly...
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| ELM
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Yes, the answer is that, but what about E? What do you think his serum sodium could be? Increased or decreased????
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| sanz
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He will be dehydrated, so i think sodium would be slightly increased... i'm not too sure tho ...
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| 2bmd
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Doesnt hypergylcemia cause hyponatremia? So if you correct the Na it should actually be closer to 145.
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| ELM
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That's exactly what i am talking about. It seems depending on the type of DM sodium level are diffirent....not sure though. In type one DM pseudohyponatriemia where as in type 2 seems normal to slightly increased sodium despite the increased blood glucose level. What's up with this :?: Doesn't make sense.....anyone figured this out????
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| yutaro
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This patient is hyperosmotic, non-ketoic coma.
DM-2 patients can have three types of coma
lactic acidosis, non-ketoic hyperosmotic and hypoglycemia.
So Serum osmolarity is greatly elevated.
Answer is C
As for sodium, This patient has pseudohyponatremia.
132 is not so low for her. and this is not so diagnostic.
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| r753_2000
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for coma to occur serum osmolality must exeed 320-330 mosm/kg. if it reaches 310 osm/kg, you get lethargy and confusion.
serum sodium must exceed 140 meq/L to produse an osmolality of 330-440 mosm/kg.
In this case, the choice with the serum sodium is still too low to cause coma; therefore it would not correlate in this case.
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| ELM
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There you go! :lol:
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| r753_2000
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where did you find this question?
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| ELM
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2004 kaplan q book, p-229, q#11.
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| r753_2000
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Does Kaplan Lecture notes provide the explanation for that?
or is the explanation found only on Qbook?
I heard that Kaplan lecture notes are not COMPLETE. That you have to do some research for some areas...
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| ELM
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Depending on an individual's goal one can get away with Kaplan notes for to pass the or even can do better than that but if one is wishing more than that or going for a VERY high score....Kaplan it self is not enough....at least that's what i think. Nothing by itself is enough for this kind of tests.....you have to have multiple sourses to do really well.
For this particular q..... Q book explanation didn't say anything on the serum sodium level. So we just have to figure it out on our own.
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