Medical Emergencies · single question
An uncontrolled Type 2 diabetic patient develops a severe hyperglycemic episode. What acid-base disturbance may occur?
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Correct answer: D. Metabolic acidosis
- A. Respiratory acidosis results from hypoventilation (COPD, opioid overdose) — not the primary disorder in diabetic hyperglycemic emergencies.
- B. Respiratory alkalosis occurs from hyperventilation (anxiety, early salicylate toxicity) — not the primary disorder in uncontrolled diabetes.
- C. Metabolic alkalosis (high pH, high HCO3) results from vomiting, diuretic use, or excess alkali ingestion — not from uncontrolled diabetes.
- D. CORRECT. Severe uncontrolled Type 2 diabetes can lead to hyperosmolar hyperglycemic state (HHS) or, less commonly, diabetic ketoacidosis (DKA, more classic in Type 1). In both conditions, accumulation of ketoacids (DKA) or lactic acid from poor perfusion leads to metabolic acidosis (low pH, low HCO3, compensatory low pCO2).
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