試題詳解

56. A 54 y/o diabetic female patient with 4 days of fever, respiratory symptoms and dyspnea. At emergency service, physical examination revealed postural hypotension, tachycardia, and Kussmaul respiration. Laboratory tests were: blood glucose level of 385 mg/dL. The arterial pH is 7.35, pCO₂ is 22 mm Hg, pO₂86 mmHg, 14 mEq/L. Serum electrolyte values were: Na 130 meq/L； K 5.1 meq/L； Cl 96 meq/L； Chest x-ray film indicated consolidation of bilateral lower lobe. Which of the following statements is most likely to be true?
 (1)The patient has respiratory acidosis, possibly related to pneumonia
 (2)The patient has metabolic acidosis, possibly related to diabetes
 (3)The patient has respiratory alkalosis, possibly related to pneumonia
(4)The anion gap is still within normal range
 (5)Be cautious with hyperphospatemia during combined insulin and glucose therapy 
(A) (1)+(2)+(5)。
(B) (1)+(2)+(4)+(5)。
(C) (2)+(3)+(5)。
(D) (2)+(3)。
(E) (2)+(3)+(4)。