A 79-year-old with long-standing T2DM, confusion, glucose 41 mmol/L, osmolality high, ketones negative. Initial fluid strategy for HHS?...

Question

A 79-year-old with long-standing T2DM, confusion, glucose 41 mmol/L, osmolality high, ketones negative. Initial fluid strategy for HHS?

Accepted Answer

0.9% saline cautiously with close monitoring

Answer

10% dextrose infusion first

Answer

0.45% saline bolus

Answer

Insulin bolus 10 units IV then fluids

Answer

No IV fluids; start metformin

mrcp part 1 MCQ (SBA): HHS