Which of the following measures is not an essential component of the management of moderately severe diabetic ketoacidosis:

Correct Answer: D

Rationale: The correct answer is D: Sodium bicarbonate. In diabetic ketoacidosis, the blood becomes acidic due to ketone accumulation. Administering sodium bicarbonate can worsen the acidosis by shifting the pH too rapidly. Insulin is essential to lower blood glucose levels, IV fluids are necessary to correct dehydration, and potassium chloride is needed to replenish electrolytes. Sodium bicarbonate is not recommended as it can lead to potential complications.

Correct Answer: D

Rationale: Rationale: Rosiglitazone is the correct answer as it is not a sulfonylurea but acts by a similar mechanism to enhance insulin sensitivity in peripheral tissues, unlike sulfonylureas that directly stimulate insulin release from pancreatic beta cells. Glimepiride, Repaglinide, and Miglitol are sulfonylureas or alpha-glucosidase inhibitors, which directly stimulate insulin release or delay carbohydrate absorption, respectively, making them unsuitable choices for the question.

Correct Answer: A

Rationale: The correct answer is A: Acarbose. Acarbose inhibits intestinal brush border α-glucosidase enzymes, leading to delayed carbohydrate digestion and absorption. This mechanism helps in controlling postprandial blood glucose levels. Pioglitazone (B) improves insulin sensitivity, Metformin (C) reduces hepatic glucose production, and Guargum (D) is a dietary fiber with no direct impact on α-glucosidase enzymes.

Correct Answer: D

Rationale: The correct answer is D because glucocorticoids promote gluconeogenesis in the liver, increasing glucose production, and depress glucose uptake into skeletal muscles, leading to hyperglycemia. Choice A alone is correct as it contributes to elevated blood glucose levels. Choice B also plays a role by reducing glucose utilization in muscles. Choice C is incorrect as glucocorticoids do not directly inhibit insulin secretion. These mechanisms collectively contribute to impaired carbohydrate tolerance in individuals taking glucocorticoids.

Correct Answer: A

Rationale: Rationale: 1. Hydrocortisone is a natural glucocorticoid with significant mineralocorticoid activity. 2. It binds to both glucocorticoid and mineralocorticoid receptors. 3. This dual activity can lead to sodium retention and potassium excretion. 4. Triamcinolone, Dexamethasone, and Betamethasone are synthetic glucocorticoids with minimal mineralocorticoid effects. Summary: - Triamcinolone, Dexamethasone, and Betamethasone have negligible mineralocorticoid activity. - Hydrocortisone stands out due to its substantial mineralocorticoid effects alongside its glucocorticoid actions.