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Ketone Bodies In Urine

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Moof's Medical Biochemistry Video Course: http://moof-university.thinkific.com/... In this video, I describe how Ketone Bodies are oxidized for energy. The liver makes ketone bodies that travel through the blood to extrahepatic tissues, where they are oxidized in the mitochondrial matrix to give energy. The pathway begins with D--Hydroxybutyrate, as it is oxidized to Acetoacetate by the same D--Hydroxybutyrate Dehydrogenase reaction (except in reverse). The Acetoacetate is then activated to Acetoacetyl-CoA by -Ketoacyl-CoA Transferase (also known as Thiophorase); this second step takes a Coenzyme A from Succinyl-CoA (an intermediate of the Krebs Cycle). The Acetoacetyl-CoA is then cleaved into two Acetyl-CoA molecules that can go through the Krebs Cycle to be oxidized, resulting in energy that cell can use. Ultimately, the liver is basically sending Acetyl-CoA that it isnt metabolizing to other tissues (by way of Ketone Bodies in the blood) so that those other tissues can utilize the Acetyl-CoA. However, sometimes, the extrahepatic tissues do not oxidize the ketone bodies rapidly enough to keep up with the pace at which they are arriving from the blood. This is a problem described

Ketone Bodies (urine)

Does this test have other names? Ketone test, urine ketones What is this test? This test is used to check the level of ketones in your urine. Normally, your body burns sugar for energy. But if you have diabetes, you may not have enough insulin for the sugar in your bloodstream to be used for fuel. When this happens, your body burns fat instead and produces substances called ketones. The ketones end up in your blood and urine. It's normal to have a small amount of ketones in your body. But high ketone levels could result in serious illness or death. Checking for ketones keeps this from happening. Why do I need this test? You may need this test if you have a high level of blood sugar. People with high levels of blood sugar often have high ketone levels. If you have high blood sugar levels and type 1 or type 2 diabetes, it's important to check your ketone levels. People without diabetes can also have ketones in the urine if their body is using fat for fuel instead of glucose. This can happen with chronic vomiting, extreme exercise, low-carbohydrate diets, or eating disorders. Checking your ketones is especially important if you have diabetes and: Your blood sugar goes above 300 mg/dL Continue reading >>

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  1. Burnboy

    on a keto diet what can i drink besides water and no-carb protein shakes?

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    "May all of your showers be golden." - Jerri Blank

  2. JohnnyO

    For me a diet coke wouldn't throw me out of ketosis, but the keto sticks would be lighter. I suppose if I had enough of them it would kick me out of it.

  3. Burnboy

    bump

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    "May all of your showers be golden." - Jerri Blank

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Moof's Medical Biochemistry Video Course: http://moof-university.thinkific.com/... In this video, I detail the pathway of Ketone Body Synthesis, commonly known as Ketogenesis. Ketogenesis occurs in the mitochondrial matrix of hepatocytes (liver cells). The pathway begins with the condensation of two Acetyl-CoA molecules, forming an Acetoacetyl-CoA (catalyzed by Thiolase). The second step involves the condensation of another Acetyl-CoA molecule to form HMG-CoA (catalyzed by HMG-CoA Synthase). The third step is the cleavage of HMG-CoA, producing Acetoacetate (a ketone body), while releasing an Acetyl-CoA. Acetoacetate can 1) be decarboxylated (either spontaneous or enzymatically by Acetoacetate Decarboxylase) to yield Acetone (another ketone body) or 2) be reduced to D--Hydroxybutyrate by D--Hydroxybutyrate Dehydrogenase, requiring an NADH as a coenzyme. Its worth mentioning that this pathway does NOT occur to a great extent in healthy people under normal conditions. It happens to a very minimal extent, and very few ketone bodies are synthesized during normal physiology. For a suggested viewing order of the videos, information on tutoring, personalized video solutions, and an opportu

Evaluation Of A Nitroprusside Dip Test For Ketone Bodies

The detection of ketone bodies in urine specimens is sufficiently important to warrant the inclusion of a nitroprusside test for ketonuria as a part of the routine urinalysis. In the past, methods available have included a tablet test (Acetest) and the Rothera test, a conventional test tube procedure. Recently the nitroprusside test for urine ketones has been made available as a stick or dip test with a preparation called Ketostix. This test, like the other nitroprusside tests, depends on the reaction between acetoacetic acid and nitroprusside to produce a colored complex. In order to determine the accuracy and simplicity of the new test, it was compared with the two more standard procedures on a series of routine urine specimens in a general hospital laboratory. Tests were also carried out by experienced and inexperienced personnel on urines with and without added acetoacetic acid. The present report describes the results obtained in Continue reading >>

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  1. One of our CDI noted an elevated lactic acid and queried the physician for a diagnosis. The patient did not have Sepsis. Our physician advisor said not to do that because the next lactic acid was normal. She said we should also be looking for the underlying cause of the lactic acidosis and not querying for the diagnosis. A diagnosis of lactic acidosis will give us a CC. Other CDI's have said that if the elevated lactic acid was treated, monitored or evaluated we should be querying for the diagnosis. Does anyone have any direction on how this should be handled?
    Is lactic acidosis always inherent in other conditions and that's what we should focus on?
    What can we pick up the diagnosis by itself as a CC / when should we query to get to documented in the chart?
    Are there any other clinical parameters we should be looking at when evaluating whether we should query such as the anion gap?
    Is there a specific treatment for metabolic acidosis?
    Thank you,
    Christine Butka RN MSN
    CDI Lead
    CentraState Medical Center
    Freehold, NJ

  2. What a timely comment. Recently, our coding auditor suggested that we should always keep an eye out for the cc "acidosis". It seems to me that lactic acidosis could be inherent to the disease process of sepsis and therefore should not be captured. Any thoughts?
    Yvonne B RN CDI Salinas, CA.

  3. Hello all! I agree, I believe lactic acidosis is inherent to sepsis. It is one of the most important indicators that gives the clnician a clue that sepsis may be present. Our fluid administration policy was actually developed on the lactic acid result: the higher the number, the more fluid we bolused (in non-CHF patients, of course). In cases were Sepsis is determined not to be present, we will query the provider, providing they treated or monitored the acidosis in some manner
    Shiloh

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Ketonuria (ketone Bodies In Urine)

Ketonuria (ketone bodies in urine) Ketonuria (ketone bodies in urine) - is revealing in the urine ketone bodies. Ketone bodies - acetone, acetoacetic acid and beta-hydroxybutyric acid in urine are found together. Normally, the urine stands 20-50 mg of ketone bodies per day, are not detected by conventional qualitative tests. Ketone bodies appear in urine in impairment of metabolism of carbohydrates, fats and proteins, which is accompanied by an increase in ketogenesis in the tissues and the accumulation of ketones in the blood (ketonemia). Ketonemia can also occur when: unbalanced diet pregnancy starvation fever alcohol intoxication poisoning infectious diseases (scarlet fever, influenza, meningitis) The urine ketone bodies appear in ketonemii. Ketonuria (ketone bodies in urine) in the postoperative period due to the collapse of the protein as a result of surgical trauma. In adults, ketonuria (ketone bodies in urine) is more common in severe diabetes. Ketonuria in diabetes develops due to enhanced ketogenesis and impairments ketoliza. Leads to increased ketogenesis increased mobilization of fat from adipose tissue, reducing the formation oksalatsetata in the Krebs cycle, reducing t Continue reading >>

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  1. Boykinbaby

    Has anyone done this? I was thinking of giving it a try, cutting my carb intake way back and getting them mostly through green veggies and less dense "starch" veggies and hardly any fruit. My girl is 9 months and still breastfeeding, solids not even enough to consider part of her nutrition yet. Of course I'll up my fat and protein consumption to compensate but advice, tips, ect are greatly appreciated

  2. Renee Lee

    For what purpose would you be consciously entering ketosis for a long period of time? What do you hope to accomplish?

  3. Bethany Lannon

    I'm ebf my 5-month old daughter & I'm also almost to my peak mileage weeks of my marathon training cycle. I have been limiting my starchy veg carbs and fruits, mostly due to wanting to lose fat/gain muscle and also thanks to a carb-phobia I'm still fighting. I'm not sure if its the high running mileage, low carbs (I usually get anywhere from 90-125 carbs per day), or a combination of the two factors but my daughter's weight gain has plummeted. She's still gaining, but lets just say that as of today, she's gained less than 4 lbs since birth, and she's 5 months old. They didn't tell me her weight %ile today, but at her 4-month checkup, it was down to 8.6%. And she only gained 6oz in the last month. So, I'm reluctantly increasing my carbs... I'm going to aim for consistently 150g carbs per day and see if that helps her.
    Obviously with your baby being older, you could get away with cutting carbs *as long as* you start implementing more solids into Baby's diet. My daughter has either butternut squash or avocado 2x per day after nursing, but she's going up to 3x per day as of today (if her weight isn't up more next month at her 6mo visit, they'll talk more about intervening at that point). So, if your baby's primary calories are only coming from you, I'd suggest either holding off on dropping the carbs or implementing more solids to baby's diet first.

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