USMLE Forum Archives - USMLE Step 3 - D.M
D.M
zkadhem - 07-29-09 01:09
A 29-year-old female is admitted to the hospital for an elective cesarean section. She is on her 38th week of pregnancy. The patient was diagnosed with type 1 diabetes three years ago. She is currently on NPH (32 units before breakfast, 26 units at bedtime) and regular insulin (22 units before breakfast, 22 units before supper). Before the admission, her glucose control was acceptable, and she denied hypoglycemic symptoms. She does not have any chronic diabetes complications. The procedure is scheduled on the next day of admission. Which statement correctly describes the proper preoperative management of diabetes in this patient?
zkadhem - 07-29-09 01:09
A 29-year-old female is admitted to the hospital for an elective cesarean section. She is on her 38th week of pregnancy. The patient was diagnosed with type 1 diabetes three years ago. She is currently on NPH (32 units before breakfast, 26 units at bedtime) and regular insulin (22 units before breakfast, 22 units before supper). Before the admission, her glucose control was acceptable, and she denied hypoglycemic symptoms. She does not have any chronic diabetes complications. The procedure is scheduled on the next day of admission. Which statement correctly describes the proper preoperative management of diabetes in this patient?
The correct answer and explanation will be available after you answer.
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#2
Re: D.M conym5 - 07-29-09 09:55 My answer is: c.
c. Normal insulin dose on the night before surgery, half dose of NPH and regular insulin on the morning of surgery, followed by sliding scale insulin to maintain blood glucose below 200 mg/dl.
#18
Re: D.M bingousmle - 07-26-10 01:44 this is a high yield concept.. can somebody address the various ways in which this concept can be tested on the test? thanks in advance
#20
Re: D.M babbu5508 - 07-28-10 05:11 My answer is: d.
d. Normal insulin dose on the night before surgery, and start the patient on an insulin drip and infusion of D5 ½ NS with 40 mEq of KCl to keep the blood glucose below 160 mg/dl.
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