Which of the following items are common presenting features of diabetic ketoacidosis?

• A. Polyuria, polydipsia, nausea, vomiting, abdominal pain, fatigue, dehydration, tachypnea, fruity breath; ketonemia.
• B. Polyphagia, weight gain, dry cough.
• C. Chest pain, shortness of breath.
• D. Night sweats, weight loss

Answer: (A)

Diabetic ketoacidosis typically presents with dehydration from osmotic diuresis due to high blood glucose, plus a metabolic acidosis from ketone production. The combination of polyuria and polydipsia reflects the glucose spilling into the urine and drawing water with it; dehydration then contributes to fatigue and worsens the clinical picture. Insulin deficiency with increased counterregulatory hormones triggers lipolysis and hepatic ketogenesis, leading to ketones in the blood and a low bicarbonate state that the body tries to compensate for with rapid, deep breathing (tachypnea). Nausea, vomiting, abdominal pain, and the characteristic fruity breath from acetone are common accompanying signs. This cluster—polyuria, polydipsia, GI symptoms, dehydration, tachypnea, fruity breath, and ketonemia—matches diabetic ketoacidosis well. The other symptom patterns describe conditions unrelated to DKA, such as weight gain with dry cough, chest pain with shortness of breath, or night sweats with weight loss.