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Kaplan Qbank USMLE



Author4 Posts
  #1

What would you use to best estimate the extent of ketosis in alcoholic patient?

a. urine nitroprusside test (for acetoacetate)
b. serum thiamine levels
c. serum glucose levels
d. serum beta-hydroxybutirate levels
e. serum pH

  #2

the answer is D .. betahydroxybutyric acid .. theother two ketone bodies arent specific

  #3

Rajeev, you're right here. Beta hydroxybutyrate levels reflect the severity of ketoacidosis in alcoholics, the other ketone - acetoacetate gets converted to beta hydroxybutyrate due to excess of NADH and might not be significantly elevated in these patients.

  #4

I think we have to be careful about one more thing that the regular test which we do for detecting ketone bodies is the Nitroprusside test , unfortunjaltely there is excess of Beta hydroxy butyrate in the alcoholics and therefore it wont be detected thru the Nitroprusside test and we may consider the alcoholic patient as non ketotic, so...
so what is the test which u do for detecting the beta hydroxy butyrate







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