Starvation and diabetes mellitus can lead on to ketoacidosis. Which of the following features is in favour of ketoacidosis due to diabetes mellitus –
**Core Concept**
Ketoacidosis is a metabolic state characterized by the production of ketone bodies due to a lack of glucose as an energy source. In diabetic ketoacidosis (DKA), this occurs primarily due to insulin deficiency and hyperglycemia, whereas in starvation ketoacidosis, it is caused by a lack of glucose and a shift towards ketone body production for energy.
**Why the Correct Answer is Right**
In DKA, the presence of hyperglycemia (>250 mg/dL) and ketonuria is a hallmark. Additionally, the patient typically presents with signs of dehydration, such as dry mucous membranes and decreased urine output. The correct answer will be a feature that is more commonly associated with DKA rather than starvation ketoacidosis.
**Why Each Wrong Option is Incorrect**
**Option A:** This option is incorrect because it is a feature that can be present in both DKA and starvation ketoacidosis. Both conditions can lead to metabolic acidosis, which is characterized by a decrease in blood pH and an increase in anion gap.
**Option B:** This option is incorrect because it is a feature that is more commonly associated with starvation ketoacidosis. In starvation ketoacidosis, the body's primary source of energy is shifted from glucose to ketone bodies, leading to a decrease in glucose levels.
**Option C:** This option is incorrect because it is a feature that can be present in both DKA and starvation ketoacidosis. Both conditions can lead to a decrease in potassium levels due to urinary losses and shift of potassium into cells.
**Option D:** This option is incorrect because it is a feature that is more commonly associated with starvation ketoacidosis. In starvation ketoacidosis, the body's primary source of energy is shifted from glucose to ketone bodies, leading to a decrease in insulin levels.
**Clinical Pearl / High-Yield Fact**
A classic exam trap is to confuse the causes of metabolic acidosis. Remember that DKA is characterized by hyperglycemia, ketonuria, and dehydration, whereas starvation ketoacidosis is characterized by hypoglycemia, ketonuria, and a shift towards ketone body production for energy.
**Correct Answer: C. Hyperglycemia.**