A previously healthy 20-year-old girl is brought to the emergency department by her roommate because of abdominal pain, nausea, and vomiting for 6 hours. Over the past 6 weeks, she has also had increased frequency of urination, and she has been drinking more water than usual. She has lost 6 kg (13 lb) over the same time period despite having a good appetite. Her temperature is 37.8 C (100 F), blood pressure is 96/58 mm Hg, and pulse is 112/min She appears lethargic. Physical examination shows dry mucous membranes and her urine has a strong, fruity odor. Laboratory results are as follows: Based on the current laboratory findings, which of the following is most likely occurring in this patient?

Question

A previously healthy 20-year-old girl is brought to the emergency department by her roommate because of abdominal pain, nausea, and vomiting for 6 hours. Over the past 6 weeks, she has also had increased frequency of urination, and she has been drinking more water than usual. She has lost 6 kg (13 lb) over the same time period despite having a good appetite. Her temperature is 37.8 C (100 F), blood pressure is 96/58 mm Hg, and pulse is 112/min She appears lethargic. Physical examination shows dry mucous membranes and her urine has a strong, fruity odor.  Laboratory results are as follows:  Based on the current laboratory findings, which of the following is most likely occurring in this patient?

Quizplus · Accepted Answer

Eductional Objective: Normally, metabolic acidosis is partially compensated for by respiratory alkalosis. When the steady-state PaCO₂ persists above the range given by the Winter formula (PaCO₂ = (1.5 * HCO₃-) + 8 ± 2), the patient has a superimposed respiratory acidosis (respiratory failure).

A Previously Healthy 20-Year-Old Girl Is Brought to the Emergency