Welcome to The Pearl Log — where post-shift wisdom surfaces, one shiny clinical take at a time. Some pearls are fresh, some are rough, all are found under pressure.
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Diabetic KetoALKALOSIS
Sometimes DKA doesn’t read the textbook.
A patient can have elevated beta-hydroxybutyrate and a wide anion gap, yet show a normal or even alkalemic pH—thanks to vomiting, volume contraction, or mixed acid-base shifts. That’s diabetic ketoalkalosis. Don’t be fooled by the “normal” blood gas; if the gap and ketones are high, treat it like DKA.