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Abstract
Plasma glucose > 250 mg/dL Arterial pH < 7.3 Presence of ketonemia and/or ketonuria Table 1 Criteria for the Diagnosis of Diabetic Ketoacidosis Signs and Symptoms % Dyspnea 73 Pleuritic chest pain 66 Cough 37 Hemoptysis 13 Tachypnea (respiratory rate > 16/min) 96 Rales 58 Accentuated second heart sound 53 Tachycardia (heart rate > 100/min) 44 Fever (temperature > 37.8°C) 43 Diaphoresis 36 S3 or S4 gallop 34 Cardiac murmur 23 Cyanosis 19 Table 2 Major Signs and Symptoms of Pulmonary Embolism Acute medical illness Venous stasis Hypercoagulable states Hereditary factors Immobilization Travel of >= 4 hours in the past month Surgery within the last 3 months Malignancy, especially lung cancer Current or past history of thrombophlebitis Trauma to the lower extremities and pelvis during the past 3 months Smoking Central venous instrumentation within the past 3 months Stroke, paresis, or paralysis Pregnancy Oral contraceptives and estrogen replacement Prior pulmonary embolism Heart failure Chronic obstructive pulmonary disease Table 3 Common Risk Factors for Deep Vein Thrombosis and Pulmonary Embolism Admission Discharge Aspirin 162 mg daily Aspirin 162 mg daily Losartan 25 mg daily Insulin glargine 35 units subcutaneously daily 3 Months Before Admission Admission Laboratory Values 3 Months After Admission Normal Values Random glucose 95 mg/dL 916 mg/dL 96 mg/dL 74-110 mg/dL Hgb A1C 5.5% 13.1% 5.2% 4%-6% Sodium 140 mmol/L 121 mmol/L 140 mmol/L 136-144 mmol/L Chloride 103 mmol/L 81 mmol/L 101 mmol/L 101-111 mmol/L Potassium 4.6 mmol/L 4.7 mmol/L 3.8 mmol/L 3.6-5.1 mmol/L GFR (blacks) 65 mL/min 30 mL/min 53 mL/min 59-180 mL/min BUN 9 mg/dL 36 mg/dL 27 mg/dL 8-20 mg/dL Creatinine 1.33 mg/dL 2.63 mg.dL 1.59 mg/dL 0.7-1.2 mg/dL Table 5 Laboratory Testing Comparison BUN = blood urea nitrogen; GFR = glomerular filtration rate; Hgb = hemoglobin.