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Biochemistry General 4d7cf2f4

A male 55 years old is brought to the clinic in an unconscious condition. The patient is a type 2 diabetic since 15 years. General examination reveals RBS levels 268 mg/dl. Blood and urine samples confirm the presence of ketone bodies. The urine sample of the patient show all of the following except:

A
β-hydroxybutyrate
B
Acetoacetate
C
Acetone
D
Glycerol 3-phosphate
High-Yield Explanation
Ketoacidosis Results From Prolonged Ketosis. Acetoacetic and 3-hydroxybutyric acids are both moderately strong acids and are buffered when present in blood or other tissues. However, their continual excretion in quantity progressively  depletes the alkali reserve, causing ketoacidosis. This may be fatal in uncontrolled diabetes mellitus. Higher than normal quantities of ketone bodies present in the blood or urine constitute ketonemia (hyperketonemia) or ketonuria, respectively. The overall condition is called ketosis. The basic form of ketosis occurs in starvation and involves depletion of available carbohydrate coupled with mobilization of FFA.  Non pathologic forms of ketosis are found under conditions of high-fat feeding and after severe exercise in the postabsorptive state.A clear understanding of the biochemical basis and pathophysiology of DKA is essential for its efficient treatment. The cardinal biochemical features are: Hyperketonaemia (≥ 3.0 mmol/L) or ketonuria (more than 2+ on standard urine sticks) Hyperglycaemia (blood glucose ≥ 11 mmol/L (approximately 200 mg/dL)) Metabolic acidosis (venous bicarbonate < 15 mmol/L and/or venous pH  < 7.3 (H+  > 50 nmol/L)). Reference: HARPERS ILLUSTRATED BIOCHEMISTRY30th ed Page no 231; Davidson page no 735

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