Sweet smell in breath

Introduction There is a sweet smell in exhalation found in diabetic ketoacidosis. Diabetic ketoacidosis (DKA): is an acute complication of diabetes. Acidosis caused by a severe deficiency of insulin caused by a sharp rise in blood sugar. An acute complication of diabetes. Acidosis caused by a severe deficiency of insulin caused by a sharp rise in blood sugar. In addition, for some ingested sweets such as eating too much glutinous rice dumplings, the patient can feel the sweet smell in the mouth, the sugar itself and the patient's diet Kind of feeling. There are also some medications that can be caused.

Cause

An acute complication of diabetes. Acidosis caused by a severe deficiency of insulin caused by a sharp rise in blood sugar.

an examination

Related inspection

Urine routine blood sugar

Most patients have polyuria a few days before the disturbance of consciousness, polydipsia, polydipsia and fatigue, followed by loss of appetite, nausea, vomiting, often accompanied by headache, lethargy, irritability, rapid breathing, and rotten apple flavor in exhalation. As the disease progresses further, there is severe water loss, decreased urine output, lethargy and even coma. Diagnosis of DKA diagnosis requires hyperglycemia, hyperkalemia, and metabolic acidosis. If the patient's blood or urine glucose, ketone body is strongly positive, can be diagnosed as DKA. The starting blood glucose level is usually between 400 and 800 mg/dl (22. 2 to 44. 4 mmol/L), but it may be higher. Plasma pH and bicarbonate decreased and anion gap increased. Initially, blood sodium levels are slightly reduced, while blood potassium is often elevated or normal high. Blood potassium 4. 5mmol / L should be considered as the basis for significant potassium loss, the need for rapid potassium. Initially, serum urea nitrogen (BUN) often increased to the expected value of pre-renal azotemia. Blood amylase is usually elevated, but DKA is rare with pancreatitis. Care should be taken to find a treatable infection.

Differential diagnosis

1. Subsequent loss of appetite, nausea, vomiting often accompanied by headache, lethargy, irritability, rapid breathing, rotten apple flavor in the exhalation (acetone) fatty acid oxidation of the product acetyl CoA, both the precursor of the ketone body, but also An inevitable way to eliminate ketone bodies, acetyl CoA is combined with oxaloacetate, a product of sugar metabolism, to form citric acid, which is then used in the tricarboxylic acid cycle. If there is not enough sugar metabolite oxaloacetate, the elimination of ketone bodies There are obstacles.

2. Breathing gas is the smell of garlic: Breathing gas is a symptom of organophosphorus pesticide poisoning. The important signs of organophosphorus pesticide poisoning are due to the increase of glandular secretion. The poisoned person has more "garlic smell" in the mouth and respiratory tract. Flavor secretion.

3. Breathing gas is a smell of urine: If the kidney is sick and causes renal failure, these poisons cannot be excreted in time, and thus will stay in the blood, causing water and salt metabolism disorders and forming uremia. When the concentration of toxic substances in the blood increases, some volatile toxic substances are excreted from the respiratory qi of the lungs, so there is a smell of urine in the uremic patients' wards.

4. Breathing gas is rancid: atrophic rhinitis is a slow-developing nasal atrophic inflammation characterized by atrophy of the nasal mucosa, periosteum and bone. Severe with a typical bad smell, called ozena. More often than adolescence, women are more common than men. Due to the growth of bacteria under the purulent sputum, the protein in the purulent sputum is decomposed and decomposed, resulting in a foul odor, called snoring.

5. Breathing gas is alcoholic: Breathing gas is a symptom of alcoholism due to alcoholism. Alcoholism refers to mental and physical disorders caused by drinking. Alcoholic dependence refers to a series of withdrawal symptoms when a chronic alcoholic person stops drinking. In fact, alcohol dependent people are often in a poisoned state. The incidence of alcoholism in China is lower than that in Western countries, but its incidence has appeared to increase in recent years and should be taken seriously. Most patients have polyuria a few days before the disturbance of consciousness, polydipsia, polydipsia and fatigue, followed by loss of appetite, nausea, vomiting, often accompanied by headache, lethargy, irritability, rapid breathing, and rotten apple flavor in exhalation. As the disease progresses further, there is severe water loss, decreased urine output, lethargy and even coma. Diagnosing DKA diagnosis requires hyperglycemia, hyperkalemia and metabolic acidosis. If the patient's blood or urine glucose, the ketone body is strongly positive, can be diagnosed as DKA. The starting blood glucose value is often between 400~800mg/ Dl (22.2~44.4mmol/L), but may be higher. Plasma pH and bicarbonate decrease, anion gap increases. Initially, blood sodium level decreases slightly, while blood potassium often increases or normal high limit. Blood potassium 4.5mmol / L should be considered as the basis for significant potassium loss, need to quickly add potassium. Initial serum urea nitrogen (BUN) often increased to the expected value of pre-renal azotemia. Blood amylase usually increased, but DKA with pancreatitis Rare. Care should be taken to find treatable infections.

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