A 19 year old woman with type 1 diabetes is brought for abdominal pain, vomiting, and rapid deep breathing after missing several insulin doses. Laboratory studies show glucose 520 mg/dL, high anion gap metabolic acidosis, and positive serum ketones. Which of the following is the major metabolic driver of her acid base disorder?
- A)Marked increase in insulin mediated glucose uptake
- B)Increased lipolysis with hepatic ketone productionGABARITO
- C)Increased renal bicarbonate regeneration
- D)Inhibition of hormone sensitive lipase
- E)Decreased hepatic gluconeogenesis
Explicação
Diabetic ketoacidosis occurs when absolute insulin deficiency allows unchecked lipolysis. Free fatty acids are delivered to the liver and converted into ketoacids, producing an anion gap metabolic acidosis. Kussmaul respirations reflect respiratory compensatio... Ver explicação completa e trilha adaptativa →