II. Mechanism
- Dipstick detects acetic acid (Acetoacetate)
- In Diabetic Ketoacidosis, Beta-Hydroxybutyrate (primary Ketone) is converted to Acetoacetate
- Confirmatory Test
- Urine
- Acetest tablet test
- Blood (preferred)
- Beta-Hydroxybutyrate
- Best Ketone test
- Basic chemistry panel
- Ketoacidosis
- Low serum bicarbonate
- Increased Anion Gap
- Normal or resolving Ketoacidosis
- Normal serum bicarbonate
- Normal Anion Gap
- Ketoacidosis
- Beta-Hydroxybutyrate
- Urine
III. Interpretation: Normal
- Negative
IV. Causes: Positive
- Dehydration
- Starvation or Low Carbohydrate Diets
- Diabetic Ketoacidosis (DKA)
- Alcoholic Ketoacidosis
- Isopropanol toxicity
- Pregnancy
V. Causes: False positive Ketones on Urinalysis
- Low Urine pH (acidic)
- Increased Urine Specific Gravity
- Phenolphthalein
- Levodopa
VI. Causes: False negative Ketones on Urinalysis
- Delayed urine exam
