skip to main content

Diabetic ketoacidosis — MCCQE Part 1 MCQ

Instant feedback + full explanation. One question, done properly.

HardAltered Level of ConsciousnessDiabetic ketoacidosisMCCQE Part 1

A 24-year-old man with type 1 diabetes presents with vomiting, abdominal pain, and confusion after missing insulin. BP is 94/56 mmHg, pulse 128/min, glucose is 31 mmol/L, venous pH 7.12, bicarbonate 8 mmol/L, ketones are positive, and potassium is 5.4 mmol/L. What is the most appropriate next step in management?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: A — Begin isotonic saline and intravenous insulin with potassium monitoring

Diabetic ketoacidosis requires urgent isotonic fluid resuscitation, intravenous insulin, and careful potassium monitoring. Routine bicarbonate is not indicated at this pH and can cause harm. Subcutaneous insulin with discharge is unsafe in severe acidosis and dehydration. Metformin has no role in acute type 1 DKA management.

Reference: Diabetes Canada Clinical Practice Guidelines