🏥 USMLE Exam Prep

A 25-year-old male with type 1 diabetes presents with nausea, vomiting, abdominal pain, glucose 650 mg/dL, pH 7.18, bicarbonate 10 mEq/L, and positive ketones. His blood pressure is 90/60 mmHg, heart rate 110 bpm. After securing airway and breathing, what is the most appropriate initial fluid resuscitation?

A Dextrose 5% in 0.45% normal saline
B 0.9% Normal Saline at 1 L/hour
C 0.45% Normal Saline at 250 mL/hour
D Lactated Ringer's solution at 500 mL/hour

✓ Correct Answer: Option B

Initial management of diabetic ketoacidosis (DKA) with significant dehydration or hypotension involves rapid infusion of isotonic saline (0.9% Normal Saline) to restore intravascular volume and improve tissue perfusion.

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