ketosis vs DKA

[MudPhud20XX]

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So the presence of anion gap diff these two right? Can anyone why? Why would you see anion gap in DKA but not in ketosis? Or am I wrong about this?

Also why is urinary ketones not useful diagnosing/managing DKA?

 

[MudPhud20XX]

So the presence of anion gap diff these two right? Can anyone why? Why would you see anion gap in DKA but not in ketosis? Or am I wrong about this?

Also why is urinary ketones not useful diagnosing/managing DKA?

Anyone?

 

[scoKraz4]

When someone presents with DKA there are other more obvious signs along with the patient history. I assume they don't to wait around for urinary ketones. That is just my logic.

 

[aspiringmd1015]

dka's a/c with beta hydroxybutryate rather than acetacticic acid, and beta hydroxybutryate isnt detecting in the urinary ketone test. Theres more specifics in that statement but thats the overall idea i have in my head. Same thing w/alcoholism btw.

 

[Instatewaiter]

So the presence of anion gap diff these two right? Can anyone why? Why would you see anion gap in DKA but not in ketosis? Or am I wrong about this?

Also why is urinary ketones not useful diagnosing/managing DKA?

You need a bunch of things which surprisingly are all found in the name. Ketosis from other sources and DKA are going to cause an anion gap. They are unmeasured anions. In addition to just ketosis, you need diabetes and you need an acidosis. If you have DM, ketosis and acidosis 99 times out of 100 it's DKA.

Urinary ketones are useful. Before the national shortage, we used to use serum ketones. When the reagent used was in shortage we then switched to urinary ketones. If your lab doesn't do them fast though, they aren't all that useful. IN part because of reagent shortage and in part because of speed, beta hydroxybutyrate has become preferred at some hospitals