A patient presents with severe dehydration and a serum glucose of 50 mmol/L. Which diagnosis is most likely?

Prepare for the CAMLPR Chemistry Test. Enhance your understanding with interactive quizzes, flashcards, and detailed explanations. Boost your confidence and readiness for exam success!

Multiple Choice

A patient presents with severe dehydration and a serum glucose of 50 mmol/L. Which diagnosis is most likely?

Extremely high blood glucose with dehydration points to a hyperosmolar hyperglycemic state. In this condition, there is severe dehydration from osmotic diuresis and very high serum osmolality, but little or no ketone production and no significant acidosis. A glucose of 50 mmol/L is far above typical levels seen in other hyperglycemic emergencies and fits HHNS more than diabetic ketoacidosis, which usually involves lower glucose with clear ketosis and acidosis. If a patient were Hypoglycemic, glucose would be low rather than extremely high. Lactic acidosis centers on elevated lactate and metabolic acidosis, not the extreme hyperglycemia described here. Diabetic ketoacidosis can have high glucose too, but not to the same extreme and it features ketones and acidosis, which are not the dominant findings in this scenario.

Extremely high blood glucose with dehydration points to a hyperosmolar hyperglycemic state. In this condition, there is severe dehydration from osmotic diuresis and very high serum osmolality, but little or no ketone production and no significant acidosis. A glucose of 50 mmol/L is far above typical levels seen in other hyperglycemic emergencies and fits HHNS more than diabetic ketoacidosis, which usually involves lower glucose with clear ketosis and acidosis.

If a patient were Hypoglycemic, glucose would be low rather than extremely high. Lactic acidosis centers on elevated lactate and metabolic acidosis, not the extreme hyperglycemia described here. Diabetic ketoacidosis can have high glucose too, but not to the same extreme and it features ketones and acidosis, which are not the dominant findings in this scenario.

More practice questions