Regarding the discussion of Case 2: Urea Cycle Disorders in Neonates: Six Case Reports. In patients with hyperammonemia, oral sodium benzoate was applied at 250-500 mg/kg/day. The rationale is that O Sodium benzoate interacts with glycine to form hippurate, which then provides a non-urea cycle pathway to remove excessive nitrogen waste by the kidneys. O Sodium benzoate interacts with glycine to form N-Acetyl Glutamate, which then stimulates the urea cycle pathway to remove excessive nitrogen waste by the kidneys. O Sodium benzoate interacts with glutamate to form N-Acetyl Glutamate, which then stimulates the urea cycle pathway to remove excessive nitrogen waste by the kidneys. O Sodium benzoate interacts with Carbamoyl Phosphate Synthase to form Carbamoyl Phosphate, which then stimulates the urea cycle pathway to remove excessive nitrogen waste by the kidneys
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- A male patient having a BMI of 35 was brought to the emergency department because of excessive frequent urination , drowsiness, vomiting, and diarrhea. Was on insulin daily until several days ago when he developed excessive thirst and frothy polyuria. For the past 3 days, he has also had headaches, myalgia, and a low grade fever. Diarrhea and vomiting began 1 day ago. The patient was advised some tests and the results were as follows Specific Gravity 1.012, Sodium 132 mEq/l, potassium 6 mEq/l pH 4.0, Alkaline Phosphatase 310 U/L, urine glucose +ve, Calcium 11 mg/dl, urine Acetone +ve, urine Protein +ve, FBS 560 mg/dl, urinary Oxalate +ve , GFR 55 ml/min, urine Acetoacetate +ve, BUN 31 mg/dL, Creatinine 3.2 mg/dL, Serum Ketones High, bicarbonate 15 mEq/l, Anion gap 13 Q:- Which lab results made you diagnose the above condition/scase scenario, A.B. is a retired 69-year-old man with a 5-year history of type 2 diabetes. Although he was diagnosed in 2015, he had symptoms indicating hyperglycemia for 2 years before diagnosis. He had fasting blood glucose records indicating values of 118–127 mg/dl, which were described to him as indicative of “borderline diabetes.” He also remembered past episodes of nocturia associated with fast foods- pizzas and KFC. At the time of initial diagnosis, he was advised to lose weight (“at least 10 lb.”), but no further action was taken. Referred by his family physician to the diabetes specialty clinic, A.B. presents with recent weight gain, suboptimal diabetes control, and foot pain. He has been trying to lose weight and increase his exercise for the past 6 months without success. He had been started on glyburide (Diabeta), 2.5 mg every morning, but had stopped taking it because of dizziness, often accompanied by sweating and a feeling of mild agitation, in the late afternoon. He…case scenario, A.B. is a retired 69-year-old man with a 5-year history of type 2 diabetes. Although he was diagnosed in 2015, he had symptoms indicating hyperglycemia for 2 years before diagnosis. He had fasting blood glucose records indicating values of 118–127 mg/dl, which were described to him as indicative of “borderline diabetes.” He also remembered past episodes of nocturia associated with fast foods- pizzas and KFC. At the time of initial diagnosis, he was advised to lose weight (“at least 10 lb.”), but no further action was taken. Referred by his family physician to the diabetes specialty clinic, A.B. presents with recent weight gain, suboptimal diabetes control, and foot pain. He has been trying to lose weight and increase his exercise for the past 6 months without success. He had been started on glyburide (Diabeta), 2.5 mg every morning, but had stopped taking it because of dizziness, often accompanied by sweating and a feeling of mild agitation, in the late afternoon. He…
- case scenario, A.B. is a retired 69-year-old man with a 5-year history of type 2 diabetes. Although he was diagnosed in 2015, he had symptoms indicating hyperglycemia for 2 years before diagnosis. He had fasting blood glucose records indicating values of 118–127 mg/dl, which were described to him as indicative of “borderline diabetes.” He also remembered past episodes of nocturia associated with fast foods- pizzas and KFC. At the time of initial diagnosis, he was advised to lose weight (“at least 10 lb.”), but no further action was taken. Referred by his family physician to the diabetes specialty clinic, A.B. presents with recent weight gain, suboptimal diabetes control, and foot pain. He has been trying to lose weight and increase his exercise for the past 6 months without success. He had been started on glyburide (Diabeta), 2.5 mg every morning, but had stopped taking it because of dizziness, often accompanied by sweating and a feeling of mild agitation, in the late afternoon. He…case scenario, A.B. is a retired 69-year-old man with a 5-year history of type 2 diabetes. Although he was diagnosed in 2015, he had symptoms indicating hyperglycemia for 2 years before diagnosis. He had fasting blood glucose records indicating values of 118–127 mg/dl, which were described to him as indicative of “borderline diabetes.” He also remembered past episodes of nocturia associated with fast foods- pizzas and KFC. At the time of initial diagnosis, he was advised to lose weight (“at least 10 lb.”), but no further action was taken. Referred by his family physician to the diabetes specialty clinic, A.B. presents with recent weight gain, suboptimal diabetes control, and foot pain. He has been trying to lose weight and increase his exercise for the past 6 months without success. He had been started on glyburide (Diabeta), 2.5 mg every morning, but had stopped taking it because of dizziness, often accompanied by sweating and a feeling of mild agitation, in the late afternoon. He…case scenario, A.B. is a retired 69-year-old man with a 5-year history of type 2 diabetes. Although he was diagnosed in 2015, he had symptoms indicating hyperglycemia for 2 years before diagnosis. He had fasting blood glucose records indicating values of 118–127 mg/dl, which were described to him as indicative of “borderline diabetes.” He also remembered past episodes of nocturia associated with fast foods- pizzas and KFC. At the time of initial diagnosis, he was advised to lose weight (“at least 10 lb.”), but no further action was taken. Referred by his family physician to the diabetes specialty clinic, A.B. presents with recent weight gain, suboptimal diabetes control, and foot pain. He has been trying to lose weight and increase his exercise for the past 6 months without success. He had been started on glyburide (Diabeta), 2.5 mg every morning, but had stopped taking it because of dizziness, often accompanied by sweating and a feeling of mild agitation, in the late afternoon. He…
- case scenario, A.B. is a retired 69-year-old man with a 5-year history of type 2 diabetes. Although he was diagnosed in 2015, he had symptoms indicating hyperglycemia for 2 years before diagnosis. He had fasting blood glucose records indicating values of 118–127 mg/dl, which were described to him as indicative of “borderline diabetes.” He also remembered past episodes of nocturia associated with fast foods- pizzas and KFC. At the time of initial diagnosis, he was advised to lose weight (“at least 10 lb.”), but no further action was taken. Referred by his family physician to the diabetes specialty clinic, A.B. presents with recent weight gain, suboptimal diabetes control, and foot pain. He has been trying to lose weight and increase his exercise for the past 6 months without success. He had been started on glyburide (Diabeta), 2.5 mg every morning, but had stopped taking it because of dizziness, often accompanied by sweating and a feeling of mild agitation, in the late afternoon. He…case scenario, A.B. is a retired 69-year-old man with a 5-year history of type 2 diabetes. Although he was diagnosed in 2015, he had symptoms indicating hyperglycemia for 2 years before diagnosis. He had fasting blood glucose records indicating values of 118–127 mg/dl, which were described to him as indicative of “borderline diabetes.” He also remembered past episodes of nocturia associated with fast foods- pizzas and KFC. At the time of initial diagnosis, he was advised to lose weight (“at least 10 lb.”), but no further action was taken. Referred by his family physician to the diabetes specialty clinic, A.B. presents with recent weight gain, suboptimal diabetes control, and foot pain. He has been trying to lose weight and increase his exercise for the past 6 months without success. He had been started on glyburide (Diabeta), 2.5 mg every morning, but had stopped taking it because of dizziness, often accompanied by sweating and a feeling of mild agitation, in the late afternoon. He…case scenario, A.B. is a retired 69-year-old man with a 5-year history of type 2 diabetes. Although he was diagnosed in 2015, he had symptoms indicating hyperglycemia for 2 years before diagnosis. He had fasting blood glucose records indicating values of 118–127 mg/dl, which were described to him as indicative of “borderline diabetes.” He also remembered past episodes of nocturia associated with fast foods- pizzas and KFC. At the time of initial diagnosis, he was advised to lose weight (“at least 10 lb.”), but no further action was taken. Referred by his family physician to the diabetes specialty clinic, A.B. presents with recent weight gain, suboptimal diabetes control, and foot pain. He has been trying to lose weight and increase his exercise for the past 6 months without success. He had been started on glyburide (Diabeta), 2.5 mg every morning, but had stopped taking it because of dizziness, often accompanied by sweating and a feeling of mild agitation, in the late afternoon. He…
- Complications of Diabetes Mellitus: All patients with diabetes mellitus develop clinically significant atherosclerosis after10 years. Up to 50% of diabetic patients develop hyperlipidemia 30% of Type I diabetic patients develop end stage renal failure All of the abovePatient A is 65 years old female. She has been diagnosed with diabetes Type II. Recently she experienced a gastrointestinal illness with nausea and vomiting. Lab data have been obtained the following day after her illness: Body weight 85 kg; Blood pressure 140/90 mmHg; Blood pH – 7.48; PCO2 – 44 mm Hg; Plasma HCO3 ion -32 mEq/L; Urine pH – 7.5. What is acid-base disorder of this patient. What was a main cause of this? The illness continues and after 2 days the following laboratory data have been obtained: Body weight 83 kg; Blood pressure 120/70 mmHg; Blood pH – 7.50; PCO2 – 48 mm Hg; Plasma HCO3 ion -36 mEq/L; Urine pH – 6.0. Has acid-base disbalance been changed? If yes, what is the explanation for this acid-base disbalance? Is there any compensation?"Flurazepam, Zaleplon, Zolpidem, Lemborexant, Ramelteon, Doxepin, Trazodone"- Among these drugs, are dose adjustment require in moderate to severe hepatic impairment or renal impairment? Please answer at your own easy words.