ABIM Endocrinology Practice Questions - ABIM Endocrinology, Diabetes, And Metabolism Certification Exam

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A 32-year-old woman with type 1 diabetes presents with a 24-hour history of nausea, vomiting, and polyuria. Labs: glucose 512 mg/dL, pH 7.12, bicarbonate 8 mEq/L, anion gap 24, beta-hydroxybutyrate 5.8 mmol/L, K+ 3.1 mEq/L. Which is the most appropriate next step?

Start IV regular insulin bolus 0.1 U/kg immediately Begin potassium replacement before starting insulin Administer IV bicarbonate Give subcutaneous glargine at home-equivalent dose

Correct Answer:

Begin potassium replacement before starting insulin

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