Question

A 43-year-old man is admitted to the hospital with diabetic ketoacidosis. Two days after admission, he develops sinus pain, congestion, and headache. During the next 4 hours, he becomes progressively confused and his blood glucose concentration remains difficult to control. His temperature is 38.3°C (100.9°F), pulse is 110/min, respirations are 14/min, and blood pressure is 122/68 mm Hg. Physical examination shows black eschars on the nasal turbinates. A CT scan of the head shows severe maxillary sinusitis with erosion of bone at the base of the orbit. Which of the following features most likely predisposed the patient to this infection? A) Decreased insulin concentrations and decreased serum phosphate concentrations B) Increased glucose concentrations and enhanced iron binding by ferritin C) Ketoacidosis and hypophosphatemia D) Ketoacidosis and increased free iron availability E) Rapid correction of hyperglycemia by insulin and decreased phosphate activity

          A 43-year-old man is admitted to the hospital with diabetic ketoacidosis. Two days after admission, he develops sinus pain, congestion, and headache. During the next 4 hours, he becomes progressively confused and his blood glucose concentration remains difficult to control. His temperature is 38.3°C (100.9°F), pulse is 110/min, respirations are 14/min, and blood pressure is 122/68 mm Hg. Physical examination shows black eschars on the nasal turbinates. A CT scan of the head shows severe maxillary sinusitis with erosion of bone at the base of the orbit. Which of the following features most likely predisposed the patient to this infection?
A) Decreased insulin concentrations and decreased serum phosphate concentrations
B) Increased glucose concentrations and enhanced iron binding by ferritin
C) Ketoacidosis and hypophosphatemia
D) Ketoacidosis and increased free iron availability
E) Rapid correction of hyperglycemia by insulin and decreased phosphate activity

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Biology for AP Courses

Julianne Zedalis, John Eggebrecht

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Solved by Expert Bryan Valdivia

06/17/2023

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These symptoms, along with the CT scan findings of severe maxillary sinusitis with bone erosion, suggest a fungal infection, most likely mucormycosis. Mucormycosis is an opportunistic fungal infection that typically affects patients with poorly controlled Show more…

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A 43-year-old man is admitted to the hospital with diabetic ketoacidosis. Two days after admission, he develops sinus pain, congestion, and headache. During the next 4 hours, he becomes progressively confused and his blood glucose concentration remains difficult to control. His temperature is 38.3°C (100.9°F), pulse is 110/min, respirations are 14/min, and blood pressure is 122/68 mm Hg. Physical examination shows black eschars on the nasal turbinates. A CT scan of the head shows severe maxillary sinusitis with erosion of bone at the base of the orbit. Which of the following features most likely predisposed the patient to this infection? A) Decreased insulin concentrations and decreased serum phosphate concentrations B) Increased glucose concentrations and enhanced iron binding by ferritin C) Ketoacidosis and hypophosphatemia D) Ketoacidosis and increased free iron availability E) Rapid correction of hyperglycemia by insulin and decreased phosphate activity

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00:01 Okay this clinical case says a 43 year old man is admitted to the hospital with diabetic ketoacidosis.

00:06 Two days after admission he develops a sign of pain, congestion and headaches.

00:11 During the next four hours he becomes progressively confused and his blood glucose concentration remains difficult to control.

00:18 His temperature is 38 so he has a fever.

00:21 A pulse is 110.

00:23 It is increased.

00:24 Exhalations are normal and blood pressure is also normal.

00:27 It says physical examination shows black scars on the nasal turbinates.

00:31 A serious scan of the head shows severe maxillary sinusitis with erosions of bone at the base of the organ.

00:39 And it says which of the following factors most likely predisposed the patient to this infection? you have here decreased insulin concentrations and decreased serine phosphate concentrations, increased glucose concentrations and enhanced iron binding by ferritin, ketocidosis and hypoglycemia, ketocidosis and increased free iron availability, or rapid correction of hyperglycemia by insulin and decreased fossil reactivity.

01:03 So the answer here is going to be option d.

01:06 Okay that says ketocidosis and increased free iron availability.

01:09 In this case this patient has a diabetic ketocidosis.

01:18 This is a complication of diabetes.

01:20 In this case you're going to produce high levels of ketones and the patient is going to have severe hyperglycemia.

01:27 Also there can be any disturbance or some disturbances in electrolytes...

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