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A 68 year old lady presents with polyuria and polydipsia for the past three months and fever, vomiting and dysuria for the past two days. There was no diarrhea or cough.

She was otherwise well before the onset of this illness, and has no history of diabetes, hypertension or dyslipidemia.

Her random plasma glucose is 55.55 mmol/l (1000 mg/dl).

Elige Estudios Relevantes
Fasting Plasma Glucose

Realizado

A fasting plasma glucose assay will be performed tomorrow morning.
Serum Electrolytes

Realizado

Serum Na+ 134 mEq/l (135 - 145)
Serum K+ 4.0 mEq/l (3.5 - 5.5)
Serum Cl- 107 mEq/l (95 - 105)
Arterial Blood Gases

Realizado

On room air:
pO2: 96 mmHg (> 70)
pCO2: 35 mmHg (35 - 45)
pH: 7.36 (7.35 - 7.45)
HCO3: 22 mmol/l (22 - 26)
saO2: 99%
Urine Culture

Realizado

Culture results will be available in three days.
Microscopy : Field full of pus cells.
Gram stain : Gram negative bacilli noted.

Elige el Manejo Adecuado
Antibiotics
IV Potassium Chloride
0.45% Saline Bolus
IV Insulin Bolus