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Diabetic Ketoacidosis — USMLE Step 2 CK MCQ

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HardDiabetic KetoacidosisDiabetic KetoacidosisUSMLE Step 2 CK

A 42-year-old has suspected DKA with pH 6.82 and severe acidaemia. What is the role of bicarbonate?

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Correct answer: CIndicated because pH <6.9

ADA consensus allows bicarbonate in severe DKA when pH <6.9 to improve vasomotor response; not routinely otherwise. Absolute contraindication (B) is false. K level (C) is not indication. pH <7.2 (D) is too liberal. Lactate infusion (E) is inappropriate. The keyed option is bicarbonate indicated because pH <6.9; routine bicarbonate is not used at higher pH values.

Reference: https://www.ncbi.nlm.nih.gov/books/#stage-9-order-5