A 19-year-old female with type 1 DM was admitted to the hospital with the following lab values: serum glucose 500 mg/dl (high),urine glucose and ketones 4+ (high),and arterial pH 7.20 (low).Her parents state that she has been sick with the "flu" for a week.Which of the following statements best explains her acidotic state?

Question

Quizplus · Accepted Answer

With insulin deficiency,lipolysis is enhanced,and there is an increase in the amount of nonesterified fatty acids delivered to the liver.The consequence is increased glyconeogenesis contributing to hyperglycemia and production of ketone bodies (acetoacetate,hydroxybutyrate,and acetone)by the mitochondria of the liver at a rate that exceeds peripheral use.
Insulin is deficient,not increased.
The patient is in acidosis,not renal failure.
Insulin is low,but the ketones are the result of fatty acid breakdown due to lack of insulin,not because of lipid storage.

A 19-Year-Old Female with Type 1 DM Was Admitted to the Hospital