endocrine and metabolic disorders
Alcoholic Ketoacidosis
Key Points
Alcoholic ketoacidosis is caused by the combined effects of alcohol and starvation on glucose metabolism; it is characterized by hyperketonemia and elevated anion gap metabolic acidosis without significant hyperglycemia. Measure serum and urine ketones and electrolytes and calculate a serum anion gap. Treat initially with IVthiamineto prevent Wernicke encephalopathy or Korsakoff psychosis, then follow up with IVdextrosein 0.9% saline. 