A 19 year old female presents to the emergency department wi…
A 19 year old female presents to the emergency department with complaints from her best friend of “she isn’t acting her normal self”. The patient is lethargic though awakens to voice, tachypneic, diaphoretic, with poor skin turgor. Her best friend reports she hasn’t felt good for two days, but has progressively worsened. The patient denies any medical problems, smoking, or drug use. She reports she is not currently sexually active. She complains of extreme thirst and fatigue. Labs: WBC 20K, H&H 17.5 & 45, Plt 450K. Na+ 129, K+ 5.6, anion gap 25, Cr 1.8, BUN 40, Ca+ 8.5, glucose 448. Serum acetone moderate. ABG: pH 7.12, CO2 22, O2 80, HCO3 8. Vitals: Temp 97.8F, Pulse 122, BP 104/54, RR 34, O2 96% on room air. What is the patient’s primary diagnosis?