Type 2 Diabetes Mellitus in Medicine / Internal Medicine — 65yo Woman | Critical Care | SMLE Q#11236

SMLE Question #11236

Medicine / Internal Medicine Critical Care

Objective: OBJ-308

Last updated: February 2026
A 65-year-old woman with type 2 diabetes mellitus and a remote myocardial infarction is admitted to the ICU with fever, dysuria, confusion, and oliguria. She remains hypotensive despite IV fluids and requires norepinephrine for septic shock. She is intubated and mechanically ventilated, but has severe hypoxemia despite FiO2 1.0. Examination shows diffuse bilateral crackles without an S3. Chest radiograph shows bilateral diffuse symmetric alveolar opacities without cardiomegaly or pleural effusions. What is the most likely diagnosis?

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