The Master Surgeon | Free Multiple Choice Questions (MCQs)

QUESTION NO

220

A 60 years old male presents to Accident and Emergency. He is vomiting and slightly confused. You find it quite difficult to obtain a history and there are no relatives or friends with him. The paramedics handed you boxes of metformin and gliclazide. On examination, his observations are as follows: HR110bpm, BP92/65, sats 98% on air, RR26/min, apyrexial. You note dry mucous membranes and possibly sunken eyes. He has mild abdominal tenderness and is disorientated but there are no other findings. The nurse tells you that a blood glucose reading came back as high and his ketone level was 1mmol/L. Which of the following treatments will you start first?

Please select one of the following:

Insulin sliding scale
Fixed rate insulin infusion
Oxygen
Intravenous fluids
Heparin

Question By Dr Ley Taing Chan MBBS, BA.