A patient's breath smells of acetone, which most likely indicates which of the following?
a. diabetic ketoacidosis c. poor oral hygiene
b. fetor hepaticus d. uremia
A
Acetone or "fruity" breath is common in patients who are malnourished or who have uncontrolled diabetes mellitus. Ketoacidosis results from the incomplete metabolism of fatty acids. The patient may also be on a low-carbohydrate diet. This condition is also commonly seen in starvation, a high-fat diet, following anesthesia, or in pregnancy. Fetor hepaticus is the musty smell of the breath of a patient in liver failure and is caused by the breakdown of nitrogen compounds. The breath of a patient with poor oral hygiene smells foul and is called halitosis. A patient's breath that smells of ammonia is due to end-stage renal failure (uremia) because of the inability to eliminate urea.
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