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A 19 year old pregnant insulin dependent diabetic femal was admitted with a history of polyuria and polydipsia (thirst). There was poor compliance with medical therapy. Pt was afebrile, chest was clear, peripheral circulation was adequate with BP 105/65. Perioral herpes was present.Lab data: Na 136, K 4.8, Cl 101, anion gap 25, glucose 19.0, urea 8.1 and creatinine 0.09. Urinalysis: 2+ ketones, 4+ glucose.

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