A patient taking empagliflozin has vomiting, pH 7.19, bicarbonate 11 mmol/L, anion gap 25, beta-hydroxybutyrate 5.5 mmol/L and glucose 9.2 mmol/L.

Question

A patient taking empagliflozin has vomiting, pH 7.19, bicarbonate 11 mmol/L, anion gap 25, beta-hydroxybutyrate 5.5 mmol/L and glucose 9.2 mmol/L. What treatment principle is correct?

Accepted Answer

Treat as DKA with isotonic fluid, potassium-guided insulin and early dextrose

Answer

Treat as alcoholic ketoacidosis with thiamine and carbohydrate alone

Answer

Treat as lactic acidosis with bicarbonate infusion and omit insulin

Answer

Treat as HHS with hypotonic fluid and defer dextrose until normoglycemia

Answer

Treat as starvation ketosis with dextrose alone and continue daily empagliflozin therapy

Primary spontaneous pneumothorax — RCPSC EM MCQ

A patient taking empagliflozin has vomiting, pH 7.19, bicarbonate 11 mmol/L, anion gap 25, beta-hydroxybutyrate 5.5 mmol/L and glucose 9.2 mmol/L. What treatment principle is correct?