An overweight 55-year-old single woman from a rural farming area was brought to the emergency department by her neighbor.The woman had a large abscess on the bottom of her foot; she was irritable and complained of blurred vision and of being thirsty.Her breathing was rapid.The neighbor said that the only medication the woman was using was for blood pressure and sometimes an aspirin.Blood and urine samples were collected.Arterial blood gas results were: pH 7.2; PCO₂ 47 mm Hg; HCO₃ 8 mmol/L.Blood glucose was 340 mg/dL and a high anion gap was calculated.Urine glucose and ketones were markedly increased.Based on the laboratory values and symptoms of the woman,what is the most likely cause of her acid-base disorder?

Question

Quizplus · Accepted Answer

The arterial blood gas results indicate metabolic acidosis with respiratory compensation (elevated PCO2). The high anion gap and marked urine glucose and ketones suggest diabetic ketoacidosis as the most likely cause of the acid-base disorder. The patient's blurred vision and thirst can also be attributed to hyperglycemia, which is a hallmark symptom of DKA. Abscess formation and infection may cause an inflammatory response but do not typically cause metabolic acidosis. Pneumonia may cause respiratory acidosis, but the blood gas results do not support this diagnosis. Hysteria is not a medical condition and is not a likely cause of the patient's symptoms.

An Overweight 55-Year-Old Single Woman from a Rural Farming Area