Endocrinology: 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

Sample item

What is the first step in the management of diabetic ketoacidosis?

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

The answer and the reasoning

B. Intravenous isotonic saline

DKA patients are profoundly volume depleted. Isotonic saline is started first to restore perfusion, followed by a fixed-rate insulin infusion once potassium is confirmed above 3.3 mmol/L. Potassium is added when levels are low or normal, and bicarbonate is rarely needed.

Option by option

  • A. Insulin bolus

    Insulin before fluids and before knowing the potassium can cause dangerous hypokalaemia and shock.

  • B. Intravenous isotonic saline (correct)

    Correct. Fluids come first, and also begin to lower glucose and ketones.

  • C. Sodium bicarbonate infusion

    Bicarbonate is reserved for severe acidosis and carries risks such as hypokalaemia.

  • D. Immediate potassium supplement without a level

    Potassium replacement depends on the measured level; giving it blindly is unsafe.

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.

More General Medicine questions

Questions about this General Medicine question

What is the answer to this General Medicine question?

The best answer is B, Intravenous isotonic saline. DKA patients are profoundly volume depleted.

Why is "Insulin bolus" not the answer?

Insulin before fluids and before knowing the potassium can cause dangerous hypokalaemia and shock.

Why is "Sodium bicarbonate infusion" not the answer?

Bicarbonate is reserved for severe acidosis and carries risks such as hypokalaemia.

Why is "Immediate potassium supplement without a level" not the answer?

Potassium replacement depends on the measured level; giving it blindly is unsafe.

What concept does this question test?

It tests Endocrinology in General Medicine. Isotonic saline is started first to restore perfusion, followed by a fixed-rate insulin infusion once potassium is confirmed above 3.3 mmol/L. Potassium is added when levels are low or normal, and bicarbonate is rarely needed.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. 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?

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.