NBME 18 Arterial PCO2 down Arterial HC)3- down Anion Gap Up (NBME Answers)

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Retired NBME 18 Answers

nbme18/Block 4/Question#21 (reveal difficulty score)
14 yo girl with T1DM is brought to the ED ...
Arterial PCO2 down Arterial HC)3- down Anion Gap Up 🔍 / 📺 / 🌳 / 📖
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submitted by ∗cbreland(195)

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She has DKA, due to the ketones in her blood

Type of increased Anion Gap metabolic acidosis (MU D PILES), meaning that HCO3- is decreased (all met. acidosis have decreased HCO3-)
Breathing fast to get rid of acid --> decreased Pco2

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jbrito718 i made the mistake of thinking that because shes vomiting, shed have increased HCO3 for every H+ loss, without realizing that her ketoacidotic state would neutralize the extra HCO3 in her blood +1

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