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Exam questionKROK 2Medicine · 2025

A 60-year-old patient has been hospitalized in an unconscious state. According to the patient's medical history, he has diabetes mellitus and arterial hypertension and takes insulin and hypotensive drugs. Objectively, the patient's condition is severe, the skin is dry, the turgor is reduced, the tongue is dry and has a brown coating, the tone of the muscles and eyeballs is reduced. Body temperature 38.2°C, Pulse 108/min, of poor volume. Auscultation detects muffled heart sounds. Blood pressure 90/50 mm Hg, the breathing is rapid and shallow. There is no smell of acetone. Blood test: glucose 58 mmol/L, total protein 105g/L, urea 16 mmol/L, sodium 238 mmol/L, potassium 5.5 mmol/L, lactic acid 0.8 mmol/L. Urinalysis: glucose 15 mmol/L, no ketone bodies. What type of coma has most likely occurred in the patient?

Answer options

  1. Hyperosmolar coma
  2. Ketoacidotic coma
  3. Hepatic coma
  4. Uremic coma
  5. Lactic acid coma
Correct answer

Hyperosmolar coma

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