USMLE Step 1 Quiz
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ENDOCRINE SYSTEM
Question 1 of 20
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A 68-year-old man with a history of poorly controlled type 2 diabetes is brought to the emergency department by his family due to progressive confusion over the past few days. He has had a productive cough and fever. Examination reveals severe dehydration. Laboratory results show a plasma glucose of 950 mg/dL, serum sodium of 150 mEq/L, and a calculated serum osmolality of 360 mOsm/kg. Arterial blood gas shows a pH of 7.35 and serum ketones are negative.
The absence of significant ketoacidosis in this patient is best explained by the presence of which of the following?
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