AAMC FL Practice Exam

In a state of ketoacidosis, which of the following conditions is most likely to occur?

1. Decrease in blood pH

2. Increase in blood glucose levels

3. Stable electrolyte balance

4. Decrease in ketone body production

The correct answer is: Decrease in blood pH

In a state of ketoacidosis, a decrease in blood pH is most likely to occur due to the accumulation of ketone bodies in the blood. When there is insufficient insulin, as seen in uncontrolled diabetes mellitus, the body begins to break down fatty acids for energy. This leads to the production of ketone bodies, which are acidic. As the levels of these acids rise, they lower the blood pH, resulting in acidosis. In contrast, blood glucose levels typically increase during ketoacidosis due to insulin deficiency, which prevents the uptake of glucose by the cells. This situation directly contradicts the notion of stable electrolyte balance, as acidosis can disrupt electrolyte levels, particularly potassium. Moreover, the production of ketone bodies is markedly increased in ketoacidosis rather than decreased, as the body is essentially in a state of metabolic panic, utilizing fat as an alternative energy source when glucose is not available. Thus, the decrease in blood pH is the hallmark condition that signifies the severity of ketoacidosis.