Diabetes Mellitus USMLE Step 1 Practice Question
A 17-year-old girl with type 1 diabetes mellitus presents with abdominal pain, vomiting, and confusion after missing several insulin doses. She is tachypneic and dehydrated. Laboratory studies show glucose 480 mg/dL, bicarbonate 10 mEq/L, anion gap elevated, serum ketones positive, and potassium 5.4 mEq/L. Which of the following is the best initial management?
Answer choices
- APhenoxybenzamine and propranolol
- BFluid resuscitation, intravenous insulin, and potassium monitoring with replacement as neededCorrect answer
- CImmediate bicarbonate infusion as sole therapy
- DDesmopressin and water restriction
- EMethimazole and propranolol
- FSodium bicarbonate infusion followed by subcutaneous insulin and oral hydration
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