A 17-year-old girl with type 1 diabetes mellitus presents with abdominal pain, vomiting, and confusion after missing several insulin doses. She is tachypneic and dehydrated. Laboratory studies show glucose 480 mg/dL, bicarbonate 10 mEq/L, anion gap elevated, serum ketones positive, and potassium 5.4 mEq/L. Which of the following is the best initial management?
- A)Phenoxybenzamine and propranolol
- B)Fluid resuscitation, intravenous insulin, and potassium monitoring with replacement as neededGABARITO
- C)Immediate bicarbonate infusion as sole therapy
- D)Desmopressin and water restriction
- E)Methimazole and propranolol
Explicação
DKA results from severe insulin deficiency leading to lipolysis, ketogenesis, hyperglycemia, dehydration, and anion gap acidosis. Initial management includes fluids, IV insulin, and potassium monitoring. Ver explicação completa e trilha adaptativa →