Audio Qbank – Q152 – A 15F with disorientation and lethargy

 

A 15-year-old girl is brought to the emergency department because of a 6-hour history of confusion, disorientation, and lethargy. She reports being thirsty and has been using the bathroom a lot. Vitals are: temperature 98.6F, HR 100, RR 22, BP 100/70. Laboratory studies show a serum glucose of 420 mg/dL and an arterial pH of 7.17. Arterial blood gas analysis is most likely to show which of the following?

 

  ↑ HCO3; ↑ pCO2; ↑ Anion gap
  ↑ HCO3; ↑ pCO2; ↔ Anion gap
  ↑ HCO3; ↓ pCO2; ↑ Anion gap
  ↑ HCO3; ↓ pCO2; ↔ Anion gap
  ↓ HCO3; ↑ pCO2; ↑ Anion gap
  ↓ HCO3; ↑ pCO2; ↔ Anion gap
  ↓ HCO3; ↓ pCO2; ↑ Anion gap
  ↓ HCO3; ↓ pCO2; ↔ Anion gap

 

Cut-to-the-chase Answer (0:58):
HY USMLE Answer (3:59):