NREMT Emergency Medical Technician (EMT) Cognitive ExamMedical EmergenciesMedium
A 72-year-old male, known diabetic, is found unresponsive by his family. His skin is warm and dry, and he has deep, rapid respirations with a fruity odor to his breath. His blood glucose level is 480 mg/dL. What is the most likely cause of his condition?
- ADiabetic ketoacidosis (DKA)
- BHypoglycemia
- CInsulin shock
- DHyperosmolar hyperglycemic state (HHS)
Show answer & explanationAnswer & explanation
Correct answer: A. Diabetic ketoacidosis (DKA)
The patient's symptoms of unresponsiveness, warm dry skin, deep rapid respirations (Kussmaul's respirations), fruity breath odor, and a very high blood glucose level (480 mg/dL) are classic indicators of diabetic ketoacidosis (DKA).
Why the other options are wrong
- B. Hypoglycemia would present with low blood glucose, cool/clammy skin, and potentially altered mental status, but not deep rapid breathing or fruity breath.
- C. Insulin shock is another term for severe hypoglycemia, which is incorrect given the high blood glucose.
- D. Hyperosmolar hyperglycemic state (HHS) also involves very high blood glucose and dehydration but typically lacks the ketoacidosis, Kussmaul's respirations, and fruity breath odor.
Diabetic Ketoacidosis (DKA)
A serious complication of diabetes that occurs when your body produces high levels of blood acids called ketones, often due to insufficient insulin.
- High blood glucose (>250 mg/dL)
- Kussmaul's respirations (deep, rapid breathing)
- Fruity breath odor (acetone)
- Dehydration, altered mental status
Memory trick: Sugar High, Acid Fry