Endocrinology: diabetic ketoacidosis: practice question

A General Medicine question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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General Medicine · Endocrinology: diabetic ketoacidosis

Sample item

A patient with type 1 diabetes has abdominal pain, vomiting, deep rapid breathing, glucose 26 mmol/L, and positive blood ketones. Which initial management principle is most important?

ALong-acting insulin only and dischargeBPrompt isotonic fluid resuscitation with protocol-guided insulin and potassium monitoringCImmediate bicarbonate in every caseDFluid restriction

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Prompt isotonic fluid resuscitation with protocol-guided insulin and potassium monitoring

Diabetic ketoacidosis requires urgent fluid replacement, insulin therapy, close potassium monitoring and replacement as indicated, and treatment of the precipitating cause. Protocols guide the sequence and rate of therapy.

Option by option

A. Long-acting insulin only and discharge
Long-acting insulin alone cannot safely correct acute ketoacidosis.
B. Prompt isotonic fluid resuscitation with protocol-guided insulin and potassium monitoring (correct)
Correct. Fluids, insulin, and potassium surveillance are core components of DKA treatment.
C. Immediate bicarbonate in every case
Bicarbonate is reserved for selected severe acidemia rather than routine use.
D. Fluid restriction
Fluid restriction worsens the usual severe volume depletion.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this General Medicine question

What is the answer to this General Medicine question?

The best answer is B, Prompt isotonic fluid resuscitation with protocol-guided insulin and potassium monitoring. Diabetic ketoacidosis requires urgent fluid replacement, insulin therapy, close potassium monitoring and replacement as indicated, and treatment of the precipitating cause.

Why is "Long-acting insulin only and discharge" not the answer?

Long-acting insulin alone cannot safely correct acute ketoacidosis.

Why is "Immediate bicarbonate in every case" not the answer?

Bicarbonate is reserved for selected severe acidemia rather than routine use.

Why is "Fluid restriction" not the answer?

Fluid restriction worsens the usual severe volume depletion.

What concept does this question test?

It tests Endocrinology: diabetic ketoacidosis in General Medicine. Protocols guide the sequence and rate of therapy.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Endocrinology: diabetic ketoacidosis?

For each disease know the classic presentation, the best test, and the first-line treatment. Then use the flashcards and the other General Medicine questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.