A 62-year-old with T2D and suspected HHS has glucose 860 mg/dL, serum osmolality 330 mOsm/kg, pH 7.37, trace ketones. Initial management priority?...

Question

A 62-year-old with T2D and suspected HHS has glucose 860 mg/dL, serum osmolality 330 mOsm/kg, pH 7.37, trace ketones. Initial management priority?

Accepted Answer

Aggressive isotonic fluid resuscitation first

Answer

Immediate insulin bolus before fluids

Answer

Sodium bicarbonate infusion

Answer

Dextrose-containing fluids initially

Answer

Wait for anion gap before treatment

us-abim MCQ (SBA): Hyperosmolar Hyperglycemic State