Question:medium
Which of the following is true in ketoacidosis?
Which of the following is true in ketoacidosis?
Show Hint
Ketoacids consume bicarbonate and widen the anion gap; lactate belongs to lactic acidosis.
Updated On: Jun 24, 2026
- Decreased HCO3
- Increased levels of lactate
- Glucose level < 250 mg/dl
- Normal anion gap
Show Solution
The Correct Option is A
Solution and Explanation
Frame ketoacidosis as an acid load problem. The body is generating large amounts of ketoacids because of insulin deficiency and unrestrained fat breakdown. Every ketoacid releases a hydrogen ion, and the immediate chemical defence against any acid load is bicarbonate, the principal extracellular buffer. As bicarbonate neutralises those hydrogen ions it is used up, so the measured serum bicarbonate drops. That falling bicarbonate is the true statement here.
The other options describe either the wrong disorder or the wrong direction. Elevated lactate belongs to lactic acidosis, a separate high anion gap acidosis, not to ketoacidosis. The anion gap in ketoacidosis is widened, not normal, precisely because the negatively charged ketoanions are unmeasured by routine electrolytes. And in the textbook diabetic presentation, blood glucose is markedly elevated, usually far above 250 mg/dl, so a sub-250 value is not characteristic.
Putting the chemistry together, the consistent and defining finding is consumption of bicarbonate.\[\boxed{\text{Decreased HCO}_3}\]
The other options describe either the wrong disorder or the wrong direction. Elevated lactate belongs to lactic acidosis, a separate high anion gap acidosis, not to ketoacidosis. The anion gap in ketoacidosis is widened, not normal, precisely because the negatively charged ketoanions are unmeasured by routine electrolytes. And in the textbook diabetic presentation, blood glucose is markedly elevated, usually far above 250 mg/dl, so a sub-250 value is not characteristic.
Putting the chemistry together, the consistent and defining finding is consumption of bicarbonate.\[\boxed{\text{Decreased HCO}_3}\]
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