A 77-year-old woman presents with confusion. Her glucose is 980 mg/dL, serum osmolality is 340 mOsm/kg, pH is 7.38, and there are minimal ketones. Wha...

Question

A 77-year-old woman presents with confusion. Her glucose is 980 mg/dL, serum osmolality is 340 mOsm/kg, pH is 7.38, and there are minimal ketones. What initial therapy is the priority?

Accepted Answer

Aggressive isotonic crystalloid resuscitation

Answer

Immediate insulin bolus then infusion at 0.14 units/kg/h

Answer

Bicarbonate infusion

Answer

Empiric mannitol

Answer

Restrict fluids until sodium normalizes

us-usmle-step-2 MCQ (SBA): HHS

A 77-year-old woman presents with confusion. Her glucose is 980 mg/dL, serum osmolality is 340 mOsm/kg, pH is 7.38, and there are minimal ketones. What initial therapy is the priority?