Good Morning everyone.
A 15yo M referred by PCP for new onset DM; hyperglycemia of 502.
VS: BP 120/79 Pulse 95 Temp 98.6 °F (37 °C) Resp 20 SpO2 97% Wt 56.6 kg (124 lb 12.5 oz) BMI 16.02 kg/m²
Unremarkable exam besides mild-moderate dehydration
VBG pH7.366, pCO2 43, bicarb 24.6 BE 1.0
Serum bicarb 19; anion gap 19. BMP 134/4.9/96/19/455/8/0.74
CBG down to 383 with 10ml/kg NS
In the definition of DKA anion gap was not factored. Will you manage as DKA with insulin infusion or treat as hyperglycemia with SC insulin.
PEM Fellow PGY 5
If it is conceivable, it is achievable.....
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