A 22-year-old man with type 1 diabetes ran out of insulin and presented with abdominal pain and altered mental status. DKA was confirmed and treated with IV fluids, insulin infusion and electrolyte replacement. After one day, glucose is 190, bicarbonate 20 and anion gap 10. He is alert. What is the next step in management?
سؤال مجاني 1 من 10 اليوم · اشترك وكمّل بدون حد
اعرض الإجابة
الإجابة والشرح
ادخل لحسابك عشان نحفظ إجاباتك ونوريك أخطاءك.
الإجابة: A. Resume his home subcutaneous insulin
The DKA has resolved: anion gap 10, bicarbonate 20, and he is alert. Once the gap closes, stop the insulin infusion and switch to subcutaneous basal-bolus (home) insulin, overlapping the two briefly. Waiting for glucose 120 is wrong, because the endpoint is anion-gap closure, not glucose. Oral agents are not used in type 1 DM.
ليش كل خيار صح أو غلط
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A
ليش صح
Once the anion gap closes, stop the infusion and switch to a subcutaneous basal-bolus insulin regimen.
✓ 11• Diabetes Mellitus [Slides].pdf · p. 8 -
B
ليش غلط
The infusion runs until the anion gap closes, not to a glucose target; dextrose is added once glucose reaches 200 to prevent hypoglycemia.
✓ Step Up To Medicine 6th Edition 2024 (DM).pdf · p. 17 -
C
ليش غلط
Step Up lists SGLT2 inhibitors among the drugs that precipitate DKA, and his DKA came from inadequate insulin, so oral agents are the wrong step.
✓ Step Up To Medicine 6th Edition 2024 (DM).pdf · p. 15
- المصدر
- Step Up To Medicine 6th Edition 2024 (DM).pdf · p. 17
11• Diabetes Mellitus [Slides].pdf · p. 8 - المحاضرة
- DKA & HHS · Endocrinology · Module B
- ظهر في
- MED42 ♂ EOM B