A 72-year-old man with type 2 diabetes mellitus is brought to the emergency department with lethargy and severe dehydration after several days of pneumonia. Laboratory studies show glucose 890 mg/dL, serum osmolality markedly elevated, bicarbonate 21 mEq/L, pH 7.37, and minimal serum ketones. Which of the following is the most likely diagnosis?
- A)Hyperosmolar hyperglycemic stateGABARITO
- B)SIADH
- C)Adrenal crisis
- D)Lactic acidosis from metformin
- E)Diabetic ketoacidosis
Explicação
HHS occurs most often in older T2DM patients with profound hyperglycemia, hyperosmolarity, severe dehydration, and minimal ketoacidosis. Ver explicação completa e trilha adaptativa →