skip to main content

Diabetic ketoacidosis — DIPIMC MCQ

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

ModerateMedical EmergenciesDiabetic ketoacidosisDIPIMCDipIMC

A 19-year-old with recent weight loss and several days of thirst and polyuria is now drowsy and breathing deeply, with a fruity smell on the breath. Capillary glucose reads high and capillary ketones are 5.2 mmol/L. What is the most appropriate immediate management?

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

Reveal the answer and explanation

Correct answer: A — Begin intravenous 0.9% sodium chloride and transfer urgently to hospital

The picture is diabetic ketoacidosis, and pre-hospital management centres on starting intravenous 0.9% sodium chloride to begin correcting the marked fluid deficit and transferring urgently for fixed-rate insulin and monitoring. Subcutaneous insulin on scene is not the pre-hospital priority, and absorption is unreliable in shock. Oral therapy and intravenous glucose are inappropriate. Pearl: deep sighing (Kussmaul) respiration reflects compensation for a metabolic acidosis and signals serious illness.

Reference: JRCALC Clinical Guidelines