A 55 year old male present with tachponea and metal confusion. Blood glucose 350 mg/dl , pH = 7.0 what is the most likely acid base disorder?
High-Yield Explanation
In diabetic ketoacidosis there is anincreased production of acetoacetic and b-hydroxybutyric acids,which leads to anincrease in plasma concentration of hydrogen ions.=Metabolic acidosis For cells to get energy, they will be burning fats, fats will generate FFA?FFA breaks into ketones (highly acidic)?Can damage BBB, cause encephalopathy etc. These fixed acids are buffered by all body buffers butmainly by bicarbonate. The concentration of plasma HCO3- is therefore below normal. The consumption of bicarbonate and the addition of the anions of the fixed acids to the plasma cause anelevation of theanion gap. The acidosis would stimulate thecarotid body chemoreceptors (and eventually the central chemoreceptors) to cause an increase in ventilation, which decreases aerial pCO2