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Tommy, A 9 Year Old Presents Looking Dry. His Mother Tells You He Has Been Urinating Very Frequently, Night And Day, Worse Over The Past 5 Days, With Large Volumes Of Dilute Urine. He Has Been Tested Today For Diabetes By The Gp But His Fasting Glucose Was Fine So He Was Referred. On Examination He Has 'Doughy' Feeling Skin And Thirst, With Sunken Orbits, A Dry Tongue A Heart Rate Of 120bpm And Bp Of 110/70. His Peripheries Are Fairly Warm. Eucs; Urea= 8 (2-5) Creatinine= 60 (30-70) Na= 150 (134) K= 4.0 (3.5-5.0) Bicarb 20 (18-25) And Glu= 4.0 (3.6-5.5). What Is The Likely Diagnosis? What Is A Key Sign Of This From The Physical Examination? What Does The Urea And Creatinine Tell You? When Would You Order Repeat Eucs In His Management? What Is The Main Risk Of Rehydration And How Can This Avoided?

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1. Tommy, A 9 Year Old Presents Looking Dry. His Mother Tells You He Has Been Urinating Very Frequently, Night And Day, Worse Over The Past 5 Days, With Large Volumes Of Dilute Urine. He Has Been Tested Today For Diabetes By The Gp But His Fasting Glucose Was Fine So He Was Referred. On Examination He Has 'Doughy' Feeling Skin And Thirst, With Sunken Orbits, A Dry Tongue A Heart Rate Of 120bpm And Bp Of 110/70. His Peripheries Are Fairly Warm. Eucs; Urea= 8 (2-5) Creatinine= 60 (30-70) Na= 150 (134) K= 4.0 (3.5-5.0) Bicarb 20 (18-25) And Glu= 4.0 (3.6-5.5). What Is The Likely Diagnosis? What Is A Key Sign Of This From The Physical Examination? What Does The Urea And Creatinine Tell You? When Would You Order Repeat Eucs In His Management? What Is The Main Risk Of Rehydration And How Can This Avoided?





 
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