Hyperglycemic Crises: DKA and HHS - Part 1 of 2

[floxy182]

Thank you for uploading these videos, very helpful for nursing school!

[drericstrong]

@pgcudahy: The best answer is probably that positive serum ketones is not super specific for DKA, as you can also get elevated serum ketones in "starvation ketoacidosis" (which doesn't actually require starvation per se), as well as alcoholic ketoacidosis. Labs used to report serum ketones as a dilution factor (i.e. ketones positive at 1:128, etc...), which would theoretically allow for better assessment of specificities, however, stopped doing so because physicians were overrelying on trends.

[pgcudahy]

Any idea how specific a positive serum ketone is for DKA in anion gap acidosis? A few times I've been working up an anion gap acidosis and had a positive ketone result but still thought an alternative etiology more likely. It's resulted as a binary positive/negative rather than quantitative so I assume they set the cut-off for more sensitivity rather than specificity.