A patient with diabetic ketoacidosis (DKA) presents with a high anion gap metabolic acidosis. What is the primary cause of the increased anion gap in this condition?

A Lactic acid accumulation
B Ketone body production ✓
C Renal failure
D Hyperventilation

Explanation

In DKA, the production of ketone bodies, such as acetoacetic acid and beta-hydroxybutyric acid, contributes to the high anion gap metabolic acidosis.

Mnemonic

DKA = Ketones → Anion gap ↑

Source

Harrison's Principles of Internal Medicine
Electrolytes and Acid-Base Balance Pathophysiology Acid-Base Disturbances Hard MEDICAL Confidence: high