Diabetic ketoacidosis Quiz: Ace Your Exams
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A 33-year-old woman with a history of type 1 diabetes mellitus presents with somnolence, fever, abdominal and right flank pain, and vomiting. Her symptoms started with dysuria and urinary frequency several days ago. This progressed to right flank pain and fever yesterday. She has been unable to eat or drink and has progressively become weak and tired. Temperature is 39.2 °C (102.5 °F), blood pressure is 88/62 mmHg, pulse is 130/min, respiratory rate is 24/min, and oxygen saturation is 100% on room air. On examination, she is arousable to touch. Her mucous membranes are dry and respirations are quick and deep. There is tenderness to palpation in the suprapubic region, as well as the right flank and costovertebral angle. Laboratory findings are listed below. Which of the following tests should be included in this patient’s evaluation?
| Laboratory study | Result |
| Leukocyte count | 17,000/mm3 |
| Sodium | 128 mEq/L |
| Potassium | 4.8 mEq/L |
| Glucose | 450 mg/dL |
| Lactic acid | 4.1 mmol/L |
| Beta-hydroxybutyrate | 3.9 mmol/L |
| Venous pH | 7.15 |
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