A 23-year-old man with type 1 diabetes presents with nausea, vomiting, abdominal pain, and deep rapid breathing. Laboratory results show glucose 468 mg/dL, arterial pH 7.18, serum bicarbonate 11 mEq/L, anion gap 24, and elevated beta-hydroxybutyrate. Which interpretation best explains this patient’s condition?

A 66-year-old man is admitted with HHS. Initial glucose is 1,040 mg/dL, serum osmolarity is 335 mOsm/L, and sodium is 128 mEq/L. He is hypotensive and tachycardic. Which treatment strategy is most appropriate to initiate first?

A 67-year-old man presents with acute abdominal pain, vomiting, and obstipation. CT imaging confirms small bowel obstruction with a transition point but no evidence of ischemia, perforation, or abscess. He is afebrile and hemodynamically stable. Which management approach regarding antibiotics is most appropriate?

A 72-year-old man with a history of prior abdominal surgery presents with sudden-onset severe abdominal pain, vomiting, fever, tachycardia, and hypotension. On exam, his abdomen is rigid with diffuse rebound tenderness and guarding. Laboratory studies show leukocytosis and metabolic acidosis. Which management decision is most appropriate?

A 58-year-old man presents with epigastric pain and nausea. Upper endoscopy reveals erythematous, friable gastric mucosa without ulceration. Biopsy is negative for H. pylori. He reports daily NSAID use for chronic back pain and drinks alcohol on weekends. Which management plan is most appropriate?

A 58-year-old woman with a history of abdominal surgery presents with intermittent abdominal pain and bloating over several weeks. She continues to pass flatus and has occasional bowel movements. CT imaging shows dilated small bowel loops with air present in the distal colon. Which interpretation is most accurate?

A 71-year-old man presents with progressive abdominal distention, constipation for 4 days, and mild crampy lower abdominal pain. He reports minimal nausea and has not vomited. He also notes unintentional weight loss over the past 3 months. Which diagnosis is most consistent with this presentation?

A 45-year-old woman with type 2 diabetes presents with nausea, vomiting, and abdominal pain. She recently started canagliflozin and has been following a low-carbohydrate diet. Laboratory studies reveal glucose 125 mg/dL, arterial pH 7.19, serum bicarbonate 12 mEq/L, anion gap 26, and elevated serum ketones. Which management strategy is most appropriate?

A 32-year-old man presents with a long history of intermittent solid-food dysphagia and several episodes of food impaction requiring emergency evaluation. He has a history of asthma and allergic rhinitis. Upper endoscopy reveals esophageal rings and linear furrows. Which diagnosis best explains this patient’s presentation?

When performing a transcranial Doppler examination, which type of velocities are primarily used for interpretation?