An 81-year-old man with hyperosmolar hyperglycaemic state (HHS) is drowsy. Glucose 38 mmol/L, Na⁺ 154 mmol/L, osmolality high, no ketones. What is the...

Question

An 81-year-old man with hyperosmolar hyperglycaemic state (HHS) is drowsy. Glucose 38 mmol/L, Na⁺ 154 mmol/L, osmolality high, no ketones. What is the initial priority?

Accepted Answer

Administer IV fluids cautiously (0.9% saline) and monitor osmolality

Answer

Start fixed-rate insulin 0.1 units/kg/hour

Answer

Give IV 10% dextrose bolus

Answer

Immediate potassium infusion even if K⁺ 4.8 mmol/L

Answer

Start broad-spectrum antibiotics

mrcp part 1 MCQ (SBA): HHS

An 81-year-old man with hyperosmolar hyperglycaemic state (HHS) is drowsy. Glucose 38 mmol/L, Na⁺ 154 mmol/L, osmolality high, no ketones. What is the initial priority?