Ketone Bodies, Fasting & DKA | USMLE Step 1
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A 74-year-old woman with type 2 diabetes is brought to the emergency department because of increasing confusion. She has had polyuria and thirst for a week and has been unable to obtain enough drinking water during the past two days. Her blood pressure is 94/58 mm Hg, pulse is 116/min, and mucous membranes are dry. Plasma glucose is 864 mg/dL, measured serum osmolality is 348 mOsm/kg, bicarbonate is 23 mEq/L, and β-hydroxybutyrate is 0.5 mmol/L. Venous pH is 7.38.