A 72 year old obese woman is admitted to the emergency department in an obtunded condition. Her family reports she has a history of high blood pressure and high cholesterol and only takes medicine for these problems. She has no other significant medical history. Her temperature is 37 degrees C, pulse 95/m, respirations 22/m, and blood pressure 90/60 mmH. She appears to be dehydrated and has poor skin turgor. Herserum glucose: 872 m/. Urinalysis: 4+glucosuria, Ketones-NEGATIVE, protein-NEGATIVE, blood-NEGATIVE.
Question 1b: Given these clinical manifestations, what would you expect his diagnosis to be?
a. hypoglycemic coma
b. hyperosmolar hyperglycemic syndrome (HHS)
c. Cushing's disease
d. diabetic ketoacidosis (DKA)
e. Addison's disease