What is the answer to the following question? And why?

An untreated patient with which one of the following conditions is MOST LIKELY to present with (relative to a healthy individual) decreased plasma bicarbonate and decreased total body sodium?

  • (a) diabetic ketoacidosis
  • (b) carbon monoxide poisoning
  • (c) anaphylactic shock
  • (d) severe iron-deficiency anaemia
  • (e) a panic attack and hyperventilation
  • 2
    Is this homework? And what steps have you taken to answer this yourself? Sep 26, 2017 at 5:23
  • 1
    We have a similar rule like Biology that homework questions are off topic. If this is an MCAT question or something that you're looking for clarification on, please specify that.
    – DoctorWhom
    Sep 28, 2017 at 7:00

1 Answer 1


Carbonic Acid / Bicarbonate Buffer System

CO2 + H2O ↔ H2CO3 ↔ H+ + HCO3

Metabolic Acidosis and DKA

Includes the following:

  • Decreased pH

  • Low HCO3 levels

  • This condition occurs when acids other than carbonic acid accumulate in ECF or when there is a loss of HCO3.

  • Rarely occurs spontaneously but in is with other problems (starvation, shock, trauma... but the answer you're looking for is.......


Diabetic Ketoacidosis (DKA)

Key Points (Information Below MerekManual Professional Version)

  • Metabolic acidosis can be caused by acid accumulation due to increased acid production or acid ingestion; decreased acid excretion; or GI or renal HCO3− loss.
  • Metabolic acidoses are categorized based on whether the anion gap is high or normal.
  • High anion gap acidoses are most often due to ketoacidosis, lactic acidosis, renal failure, or certain toxic ingestions
  • Normal anion gap acidoses are most often due to GI or renal HCO3− loss
  • Calculate delta gap to identify concomitant metabolic alkalosis, and apply Winters formula to see whether respiratory compensation is appropriate or reflects a 2nd acid-base disorder.
  • Treat the underlying cause
  • NaHCO3 is indicated when acidosis is due to a change in HCO3− (normal anion gap acidosis)
  • Intravenous NaHCO3 is controversial in high anion gap acidosis (but may be considered when pH < 7.00, with a target pH of ≤ 7.10).




Your Answer

By clicking “Post Your Answer”, you agree to our terms of service and acknowledge you have read our privacy policy.

Not the answer you're looking for? Browse other questions tagged or ask your own question.