A 17-year-old girl was adm itted to the em ergency departm ent follow ing a m otor vehicle accident. She was obtunded and responded only to pain. Medical history obtained from her m other was unrem arkable. Physical exam ination showed a patient w ith contusions on her face and arm s but no signs of cranial traum a. Vital signs were tem perature 97°F (36.1°C), blood pressure 105/70 m m Hg, pulse 112 bpm , respirations 22/m in. Pertinent serum values were bicarbonate 6 m Eq/L (norm al 22-28 m Eq/L), glucose 847 m g/dL (norm al 70-110 mg/dL), creatinine 1.1 mg/dL (norm al 0.6-1.2 m g/dL). Urinalysis showed the follow ing: speci c gravity 1.036, glucose 4+, ketones 4+. Which of the follow ing correctly pairs the m ost likely patient disorder w ith the appropriate em ergency treatm ent? A. Diabetic hyperosm olar com a/intravenous (IV) regular insulin B. Acute renal failure/furosem ide C. Posttraum atic liver failure/IV acetylcysteine D. Respiratory acidosis/IV bicarbonate infusion E. Diabetic ketoacidosis/IV regular insulin
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A 17-year-old girl was adm itted to the em ergency departm ent follow ing a m otor vehicle accident.