Emergency Medical Technician (EMT) Intermediate Practice Exam

When does diabetic ketoacidosis (DKA) occur?

1. The body metabolizes carbohydrates as a primary energy source

2. The body's cells metabolize fat as an immediate energy source

3. The body has excess insulin levels

4. The body is hydrated and maintaining glucose levels

The correct answer is: The body's cells metabolize fat as an immediate energy source

Diabetic ketoacidosis (DKA) occurs when the body's cells begin to metabolize fat as an immediate energy source due to a lack of insulin. In this condition, the body is unable to use glucose effectively because there is insufficient insulin present to facilitate glucose uptake into the cells. As a result, the body turns to fat as an alternative energy source. When fat is broken down, it produces ketones as a byproduct, leading to an accumulation of these acids in the bloodstream, which can result in a dangerous state of acidosis. This shift to fat metabolism is often triggered by factors such as inadequate insulin (due to insufficient administration or an increase in insulin requirements during illness), prolonged fasting, or stress. The excess ketones cause the blood pH to lower, leading to the characteristic symptoms of DKA, including nausea, vomiting, fruity-scented breath, and altered mental status. The other options do not accurately reflect the metabolic processes involved in DKA. Metabolizing carbohydrates as a primary energy source implies that there is sufficient insulin present for glucose uptake, which is not the case in DKA. Excess insulin levels would prevent DKA since insulin promotes glucose utilization. Finally, being hydrated and maintaining glucose levels indicates normal metabolic function