NBME Step 2 CK Form 6 Inadequate production of insulin (NBME Answers)

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Retired NBME Step 2 CK Form 6 Answers

step2ck_form6/Block 2/Question#23 (reveal difficulty score)
A 17-year-old boy comes to the physician ...
Inadequate production of insulin 🔍 / 📺 / 🌳 / 📖
tags: endo

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submitted by ∗medicalmike(82)

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This boy with AGMA and +ketones in serum has DKA, a common presenting symptom of T1DM due to inadequate insulin production. Serum sodium is normal after adjusting for hyperglycemia.

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tinylilron AGMA??? +2

nayyyy Anion gap metabolic acidosis +2

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submitted by ∗step_prep7(71)

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Classic presentation of diabetic ketoacidosis in the setting of Type 1 diabetes (polyuria, polydipsia, tachypnea (to compensate for metabolic acidosis), fatigue/weakness, elevated glucose (often 300-500 mg/dL) and elevated ketones)
Younger patients can also develop type 2 diabetes, but that would more commonly be seen in a patient with elevated BMI and Type 2 diabetes almost never presents as DKA

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