What diagnosis is most likely to account for these results?

A 32-year-old man presented to the emergency department after becoming acutely unwell.

He had a 5-year history of type 1 diabetes mellitus and no other significant medical history.

On examination, he was apyrexial, his pulse was 120 beats per minute, his blood pressure was 96/58 mmHg and his respiratory rate was 32 breaths per minute.

Investigations:

random plasma glucose14.2 mmol/L

arterial blood gases, breathing 60% oxygen:

PO28.9 kPa (11.3C12.6)

PCO22.6 kPa (4.7C6.0)

pH7.10 (7.35C7.45)

H+79 nmol/L (35C45)

bicarbonate6.1 mmol/L (21C29)

base excessC18 mmol/L (±2)

What diagnosis is most likely to account for these results?
A . acute asthma
B . acute myocardial infarction
C . diabetic ketoacidosis
D . diabetic ketoacidosis and pulmonary embolism
E . salicylate poisoning

View Answer

Answer: D