Two most important tests to be done in a comatose patient with blood glucose of 750 mg/dl will be -a) Sr. creatinineb) Sr. sodiumc) Blood pHd) Blood urea

**Core Concept**
In a comatose patient with hyperglycemia, it is crucial to assess the patient's electrolyte and fluid balance, as well as their renal function to guide management. Hyperglycemia can lead to dehydration, electrolyte disturbances, and potentially, diabetic ketoacidosis or hyperosmolar hyperglycemic state.

**Why the Correct Answer is Right**
The two most important tests in this scenario are blood pH and blood urea. Blood pH assessment is necessary to rule out diabetic ketoacidosis (DKA), a life-threatening complication of diabetes characterized by hyperglycemia, metabolic acidosis, and electrolyte disturbances. Blood urea levels can indicate the patient's hydration status and renal function. In a hyperglycemic patient, a high blood urea level may indicate dehydration, while a low level may suggest hyperglycemic hyperosmolar state (HHS). Additionally, assessing blood pH can help differentiate between DKA and HHS.

**Why Each Wrong Option is Incorrect**
**Option A:** Serum creatinine is an important test, but it is not the most critical in this scenario. It can help assess renal function, but it may not provide immediate insights into the patient's hydration status or the presence of diabetic ketoacidosis.

**Option B:** Serum sodium levels are important, but they are not as immediately relevant as blood pH and blood urea in this scenario. Hyperglycemia can lead to hyponatremia, but it is not the primary concern in a comatose patient with blood glucose of 750 mg/dl.

**Option C:** While blood pH is crucial, blood urea is equally important in this scenario. Both tests provide valuable information that can guide management and help differentiate between DKA and HHS.

**Clinical Pearl / High-Yield Fact**
In a comatose patient with hyperglycemia, always remember to assess blood pH and blood urea levels to guide management and differentiate between diabetic ketoacidosis and hyperosmolar hyperglycemic state.

**Correct Answer: C. Blood pH and Blood urea.**