A 33-year-old male presented to the emergency department with sudden-onset vomiting, chills, and lethargy for the past four hours. On examination, he appeared pale, drowsy, diaphoretic, and lethargic.
His family reported that the symptoms began abruptly and without an obvious trigger. Medical history No significant prior medical history No history of head trauma, drug use, or alcohol use Initial examination Glasgow Coma Scale (GCS): 14/15 Heart rate: 120 beats/min Respiratory rate: 30 breaths/min Capillary blood glucose: 520 mg/dL Urine dipstick: Ketosis (3+) Breath with fruity odor Initial diagnosis and management Diagnosed with diabetic ketoacidosis (DKA) Initiated on insulin-based management protocol Started on fluid and electrolyte replacement therapy Laboratory findings Complete blood count: Normal Blood glucose level: 500 mg/dL Metabolic acidosis: pH 7.1 Bicarbonate: 12 mEq/L…
