A surgeon who wants to proceed despite euglycemic ketoacidosis
Unlock this station
Full access opens all 15 mock oral exams, all 39 OSCE stations and the timed seven-station circuit. One payment of $99 for 90 days, no subscription.
Door card
Mr. Brooks, a 58-year-old man, 96 kg, with type 2 diabetes, is the first case for an elective laparoscopic cholecystectomy for recurrent biliary colic. He takes metformin and empagliflozin, and he took his empagliflozin yesterday morning. He has been nauseated since midnight. His fingerstick glucose is 178 mg/dL. The labs you sent from the holding area show a venous pH of 7.24, bicarbonate 14 mmol/L, anion gap 20 and beta-hydroxybutyrate 4.1 mmol/L. His abdomen is soft and he has no fever.
The general surgeon, Dr. Lang, has come to the holding area because the case has not started. The patient is not in the room.
Your task: present your recommendation to the surgeon and agree on a plan.