Chapter 23, Problem 4CCS

Kyle Boulard, a 35-year-old male, is believed to be one of the primary causes of the a bus accident on Route 91. Passengers on the bus reported that Mr. Boulard was clearly intoxicated when he boarded the bus. According to these reports, Mr. Boulard behaved erratically, appeared disoriented, and left his seat and staggered down the aisle. Just prior to the accident, he had stumbled into the driver’s compartment. Paramedics found Mr. Boulard in a disoriented state when they arrived on the scene, but noted only minor injuries. A “fruity acetone combined with alcohol” smell was noted on his breath. What follows is a summary of the notable test results:

General	Blood	Urine
BP: 95/58	pH: 7.1	Odor: “fruity acetone”
HR: 110	Glucose: 345 mg/dl	pH: 4.3
	Ketone bodies: 22 mg/dl	Glucose: strongly positive
	Blood alcohol: 110 mg/dl

The production of large amounts of ketone bodies is often seen when glucose is not readily available as an energy source (e.g., in starvation). In Mr. Boulard’s case, large amounts of glucose are in the blood. Explain why his body is producing ketones in the presence of such large amounts of glucose.