MEDizzy - A 65-year-old man with Type I diabetes presents to the

Feed Library Learning Discuss Leaderboard Journal

General Principles (Multisystem Processes)

A 65-year-old man with Type I diabetes presents to the Emergency Department with impaired mental status and generalized muscle weakness. Laboratory tests reveal a blood glucose of 500 mg/dL, a potassium concentration of 8.3 mmol/L, an anion gap of 22 mmol/L, a PCO2 of 50 mmHg, and a bicarbonate of 14 mmol/L. The patient’s blood values are atypical in which of the following ways?

ExplanationThe normal compensation for metabolic acidosis is hyperventilation and decreased Pco2. This patient exhibited hypoventilation. Hyperkalemia is frequently observed in patients with uncontrolled diabetic ketoacidosis. The hyperosmotic extracellular fluid draws water out of cells. K+ follows the water by solvent drag. Additionally, the lack of insulin decreases the ability of K+ to enter cells. The high anion gap is produced by the ketoacids. Bicarbonate levels are reduced by the metabolic acidosis.