doc179
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look at the attachment
Attached Files:
36qn.jpg (94 KB, 191 downloads)
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| new_n_lost
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d??
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| drduck
Forum Guru
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nice Q, i don know whether i m correct.....
i feel answer is increased glucocoticoids.......i thought patient is Diabetic so the defence mechanism against hypogycemia are not so active therefore there is a fair rise in level of glucocorticoids in order to compenste for the hypoglycemia and this i feel is also responsible for the muscle weakness and tachycardia.
also the rise in potassium i think is due to the same reason that is breakdown of muscle protein for gluconeogenesis..which is bcos of raised cortisol levels...
renin level shud be elevated
aldosterone shud also increase
ACTH shud be normal....its not a hormonal disorder..
do tell me if this is not the answer....and the right answer
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| Luckyall
Forum Guru
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i go for E decreased Renin secretion
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| me007
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aldosterone deficiency (apparent) in diabetic pt.
don't remember mechanism, can't find either.
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| Luckyall
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is secondary to diabetic nephropathy, me007 
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| mytime
Go Marching in!
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OK there's been no reason to show us Y ACTH could be less.could be more as a result of low Na+ and high K+ Feedback stimulation, then glucocorticoids and DM cud happen too.
decreased renin cud also be a reason as that wud not form enough Ag and hence...... same
But I'll go with ans. A as this is type1 DM that means he's had it most his life and kidneys bad..well renin will be less too but i think they'll be more concerned about ACTH as increased ACTH wil worsen dibeates...........Just my twisted logic.....
The thing is everything seems the ans but q says most likely........Excellent q.
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| unique1
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  ...... Reduced renin .
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| me007
Forum Guru
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you mean diabetic nephropathy --> reduced renin --> reduced aldosteron -->his symptoms: low Na , high K .
and the ans is reduced renin - e.
Later will be incr ACTH due to negative feedback but now yet.
looks like true?
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| doc179
Forum Guru
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The correct answer is E. Its because of diabetic nephropathy. I will attach the file that has answer to this question with this post. Thanx for all the input. Thanx for participating.
Attached Files:
36ans.jpg (310 KB, 20 downloads)
Edited by doc179 on 04/14/07 - 03:25 PM
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| Luckyall
Forum Guru
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Exactly, me007,, thas the mechanism diabetic nephropathy --> reduced renin --> reduced aldosteron -->his symptoms: low Na , high K !!!!!!!!!!!!!!!!
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| doc179
Forum Guru
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Posts: 1,217
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sorry guys I did not notice that the whole answer file was not attached. I have reattached it. Thanx to luckyall's post I just revisited this thread to see what he has written and so I came to know that there was an error in the attachment.
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| doc179
Forum Guru
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Yes, Luckyall you were right thru out and about the reasoning as well. Very well done
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| bangledoc
Forum Senior
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Here we go
Destruction of juxtaglumerular apparatus e.g;hyaline arteriolosclerosis of afferent arterioles in DM produces hyporeninemic hypoaldosterinisom; Type 4 RTA.: Only RTA with hyperkalemia.
Thanks for nice q
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| ShweHope99.9998
Forum Fanatic
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Its a good one . Q from ???
Pl pm , if know .
Thanks
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