ETOH ketoacidosis

Q: All of the following are the features of acute alcohol (ETOH) ketoacidosis except? 

A) history of chronic alcohol abuse
B) malnutrition
C) coma
D) nausea and vomiting
E) abdominal pain 


Answer:   C

In comparison to patients with diabetic ketoacidosis, particularly patients with nonketotic hyperosmolar hyperglycemia, patients with alcoholic ketoacidosis are usually more alert and lucid. In former conditions, there is a huge osmotic diuresis resulting in rising of effective plasma osmolality. This osmotic diuresis is not a feature of alcoholic ketoacidosis, preventing these patients from the neurologic manifestations of a marked rise in the effective plasma osmolality.

#toxicology
#acid-base
#acidosis



References:

1. Wrenn KD, Slovis CM, Minion GE, Rutkowski R. The syndrome of alcoholic ketoacidosis. Am J Med 1991; 91:119.

2.  Palmer JP. Alcoholic ketoacidosis: clinical and laboratory presentation, pathophysiology and treatment. Clin Endocrinol Metab 1983; 12:381.

3. Fulop M, Ben-Ezra J, Bock J. Alcoholic ketosis. Alcohol Clin Exp Res 1986; 10:610.