Patient presented with symptoms of diabetes which are: thirst, polyuria, weight loss and fatigue with symptoms of ketoacidosis which are epigastric pain, n&v.
On examination you’ll notice kussmaul breathing pattern, low SBP, tachycardia, cold extremities ”due to dehydration.”

The most common infections may precipitate DKA are: UTI and pneumonia. So on investigations we have to send for CXR and GUE. Ofc in addition to initial tests which are RBS for hyperglycemia, ABG for acidosis, CBC for elevated WBCs, serum potassium, And you can do ECG which may show signs of acute MI.

There are some criteria for admission to CCU:
Altered mental status, sock “ SBP less than 90”, patient’s age less than 5 yrs, pregnancy, Spo2 less than 92,bicarbonate less than 10, Potassium level less than 3,5 and Ph less than 7.

That’s why when we treat them, we never stop insulin unless the Ph becomes more than 7,3 and the bicarbonate more or equal to 15 mEq/l
,blood glucose less than 200 mg/dl and the patient is able to eat.

In treatment don’t give insulin in the first hr, that may increase risk of cerebral edema and hypokalemia. Start with IV fluid only, then in the 2nd hour check the level of potassium before giving insulin because it may precipitate hypokalemia.

Few days ago I’ve seen a patient with epigastric pain and elevated level of amylase and WBCs. I thought it’s pancreatitis🥲 while it was DKA depending on other signs and symptoms.
And yes amylase level will be high in patients with DKA.

Mitochondria are highly dynamic organelles that continuously change their shape. Their main function is adenosine triphosphate (ATP) production; however, they are additionally involved in a variety of cellular phenomena, such as apoptosis, cell cycle, proliferation, differentiation, reprogramming, and aging. The change in mitochondrial morphology is closely related to the functionality of mitochondria.

When cells experience metabolic or environmental stresses, mitochondrial fusion and fission work to maintain functional mitochondria. An increase in fusion activity leads to mitochondrial elongation, whereas an increase in fission activity results in mitochondrial fragmentation.[3] The components of this process can influence programmed cell death and lead to neurodegenerative disorders such as Parkinson's disease. Such cell death can be caused by disruptions in the process of either fusion or fission.

Mitochondria can change their shape from discrete isolated organelles to a large continuous reticulum. The cellular advantages underlying these fused networks are still incompletely understood.

Cushing's triad in raised ICP

teratoma of the ovary: the most common type of ovarian germ cell tumour.
وفي رواية أخرى: سِحر

What? This is a sculpture?

My life's been a lie

It seems more like a sculpture than real thing

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Ikr😂
عجبتني وراويتها لأهلي بس جانوا ديتغدون فترزلت

الرزالة Happens all the time 🍻