Medical Emergencies · single question
A Type 2 Diabetic patient with HbA1c 6.5% feels lightheaded with racing heart during the visit. What acid-base disturbance would they MOST LIKELY have?
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Correct answer: D. Respiratory Alkalosis
Respiratory Alkalosis (D). The clinical scenario describes anxiety/sympathetic activation (lightheadedness + tachycardia). In an anxious patient, hyperventilation (fast, shallow breathing) occurs → CO₂ is blown off → blood pH rises → respiratory alkalosis.
• HbA1c of 6.5% = well-controlled diabetes (target <7%) — this patient is NOT in diabetic ketoacidosis.
• Blood glucose of 8 mmol/L = ~144 mg/dL = mildly elevated but not crisis level.
• The lightheadedness + tachycardia + anxiety = hyperventilation = respiratory alkalosis.
• Metabolic Acidosis (B): would occur in DKA (HbA1c much higher, blood glucose >300 mg/dL, Kussmaul breathing).
• Signs of respiratory alkalosis: circumoral tingling, carpal spasm, dizziness — classic panic/anxiety attack features.
• HbA1c of 6.5% = well-controlled diabetes (target <7%) — this patient is NOT in diabetic ketoacidosis.
• Blood glucose of 8 mmol/L = ~144 mg/dL = mildly elevated but not crisis level.
• The lightheadedness + tachycardia + anxiety = hyperventilation = respiratory alkalosis.
• Metabolic Acidosis (B): would occur in DKA (HbA1c much higher, blood glucose >300 mg/dL, Kussmaul breathing).
• Signs of respiratory alkalosis: circumoral tingling, carpal spasm, dizziness — classic panic/anxiety attack features.
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