A 72-year-old with hyperosmolar hyperglycemic state (HHS) presents with glucose 920 mg/dL, Na⁺ 150 mEq/L, and no significant ketosis. What is the firs...

Question

A 72-year-old with hyperosmolar hyperglycemic state (HHS) presents with glucose 920 mg/dL, Na⁺ 150 mEq/L, and no significant ketosis. What is the first priority?

Accepted Answer

Rapid isotonic fluid resuscitation (e.g., 1-1.5 L in first hour)

Answer

Start insulin infusion first

Answer

Administer bicarbonate infusion

Answer

Immediate potassium infusion regardless of level

Answer

Give subcutaneous insulin only

us-abim MCQ (SBA): HHS Management

A 72-year-old with hyperosmolar hyperglycemic state (HHS) presents with glucose 920 mg/dL, Na⁺ 150 mEq/L, and no significant ketosis. What is the first priority?