Endocrinology: diabetic ketoacidosis: practice question

A General Medicine question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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General Medicine · Endocrinology: diabetic ketoacidosis

Sample item

In diabetic ketoacidosis, why is potassium replacement often required even when initial serum potassium is normal or high?

AInsulin causes renal potassium loss before treatmentBPotassium cannot enter cells in acidosisCBicarbonate always raises potassiumDTotal-body potassium is depleted by osmotic diuresis

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Total-body potassium is depleted by osmotic diuresis

Insulin deficiency and acidosis shift potassium out of cells, masking substantial urinary total-body losses. Insulin treatment then drives potassium intracellularly, so close monitoring and replacement are essential.

Option by option

A. Insulin causes renal potassium loss before treatment
The deficit predates insulin treatment.
B. Potassium cannot enter cells in acidosis
Potassium shift is reversible; total-body loss is the issue.
C. Bicarbonate always raises potassium
Bicarbonate has variable effects and is not the explanation.
D. Total-body potassium is depleted by osmotic diuresis (correct)
Correct. Serum levels can conceal a depleted total body store.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this General Medicine question

What is the answer to this General Medicine question?

The best answer is D, Total-body potassium is depleted by osmotic diuresis. Insulin deficiency and acidosis shift potassium out of cells, masking substantial urinary total-body losses.

Why is "Insulin causes renal potassium loss before treatment" not the answer?

The deficit predates insulin treatment.

Why is "Potassium cannot enter cells in acidosis" not the answer?

Potassium shift is reversible; total-body loss is the issue.

Why is "Bicarbonate always raises potassium" not the answer?

Bicarbonate has variable effects and is not the explanation.

What concept does this question test?

It tests Endocrinology: diabetic ketoacidosis in General Medicine. Insulin treatment then drives potassium intracellularly, so close monitoring and replacement are essential.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Endocrinology: diabetic ketoacidosis?

For each disease know the classic presentation, the best test, and the first-line treatment. Then use the flashcards and the other General Medicine questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.