Question

A 27-year-old with type 1 diabetes presents with nausea and abdominal pain. Vitals: HR 110/min, BP 104/62 mm Hg. Labs: glucose 280 mg/dL, venous pH 7.28, bicarbonate 15 mEq/L, serum beta-hydroxybutyrate 3.4 mmol/L. Which statement best establishes the diagnosis?

Accepted Answer

Diagnosis requires glucose >=200 mg/dL or prior diabetes, beta-hydroxybutyrate >=3.0 mmol/L (or urine ketones >=2+), and pH <7.3 or bicarbonate <18 mEq/L

Answer

Diagnosis requires glucose >=300 mg/dL, bicarbonate <=10 mEq/L, and urine ketones 3+

Answer

Diagnosis requires anion gap >20 mEq/L regardless of ketone level

Answer

Diagnosis requires HbA1c >=9% plus ketonemia

Answer

Diagnosis requires serum osmolality >320 mOsm/kg

Practice question

A 27-year-old with type 1 diabetes presents with nausea and abdominal pain. Vitals: HR 110/min, BP 104/62 mm Hg. Labs: glucose 280 mg/dL, venous pH 7.28, bicarbonate 15 mEq/L, serum beta-hydroxybutyrate 3.4 mmol/L. Which statement best establishes the diagnosis?