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USMLE (United States Medical Licensing Examination) Practice Exam 09

Practice exam for USMLE (United States Medical Licensing Examination).

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Question 1 of 1000%
Time remaining120:00
Attempts allowedUnlimited
Difficulty mixE • M • H
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Question 1

MEDIUM

A 27-year-old man is brought to the emergency department after being found confused and breathing rapidly. He has type 1 diabetes mellitus and missed his insulin doses for 2 days due to a viral illness. Temperature is 37.8°C (100.0°F), blood pressure is 102/64 mm Hg, pulse is 118/min, and respirations are 30/min with deep, labored breathing. Arterial blood gas shows pH 7.12, PaCO2 22 mm Hg, and HCO3− 7 mEq/L. Which of the following is the most likely explanation for his low PaCO2?

Diabetic ketoacidosis causes metabolic acidosis, which stimulates peripheral chemoreceptors (carotid bodies) to increase alveolar ventilation (Kussmaul respirations), lowering PaCO2 as compensation. Central chemoreceptors respond primarily to CO2/pH in CSF rather than metabolic acidosis directly.

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