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Minimal change disease — RCPSC IM MCQ

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HardNephrologyMinimal change diseaseRCPSC IM

A patient with type 2 diabetes taking an SGLT2 inhibitor is scheduled for major elective surgery and will fast overnight. Which medication-safety plan is most appropriate?

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

Reveal the answer and explanation

Correct answer: A — Hold the SGLT2 inhibitor in advance and give sick-day instructions

Explanation lettering: E = shown as A · C = shown as B · B = shown as C · A = shown as E

E is correct: SGLT2 inhibitors should be withheld before major surgery or prolonged fasting to reduce perioperative ketoacidosis risk. A, B and D increase that risk. C is not an equivalent substitution.

Reference: Diabetes Canada, Hyperglycemic Emergencies: https://www.diabetes.ca/health-care-providers/clinical-practice-guidelines/chapter-15