A 49-year-old man arrives as ESI 2 with confusion, vomiting, and deep respirations. Glucose is 780 mg/dL, pH 7.34, bicarbonate 19 mEq/L, serum

Question

A 49-year-old man arrives as ESI 2 with confusion, vomiting, and deep respirations. Glucose is 780 mg/dL, pH 7.34, bicarbonate 19 mEq/L, serum osmolality 352 mOsm/kg, and urine ketones are trace. Which of the following is the most likely diagnosis?

Accepted Answer

Hyperosmolar hyperglycemic state

Answer

Alcoholic ketoacidosis

Answer

Septic shock without hyperglycemia

Answer

Diabetic ketoacidosis

Answer

Adrenal crisis

Hyperosmolar hyperglycemic state — ABEM Board MCQ

A 49-year-old man arrives as ESI 2 with confusion, vomiting, and deep respirations. Glucose is 780 mg/dL, pH 7.34, bicarbonate 19 mEq/L, serum osmolality 352 mOsm/kg, and urine ketones are trace. Which of the following is the most likely diagnosis?