Patient presents with Starvation Ketoacidosis, secondary to prolonged caloric restriction.  The patient reports decreased oral intake for [number] days weeks months due to [reason for restricted intake, e.g., financial hardship, anorexia nervosa, restrictive diet, etc.].  Clinical presentation includes symptomatic ketoacidosis with laboratory findings demonstrating elevated serum ketones, metabolic acidosis (low bicarbonate, low pH), and hyperglycemia or euglycemia.  Patient denies recent alcohol use.  Differential diagnosis considered diabetic ketoacidosis, alcoholic ketoacidosis, and other causes of metabolic acidosis.  Diagnosis of Starvation Ketoacidosis is supported by the clinical picture of limited caloric intake and absence of other identifiable causes of ketoacidosis.  Initial treatment includes intravenous fluids with dextrose, electrolyte monitoring and repletion (specifically potassium, sodium, and phosphate), and close monitoring of blood glucose levels.  Patient education provided regarding the importance of adequate nutrition and the risks of prolonged fasting.  Follow-up scheduled with a registered dietitian for nutritional counseling.  ICD-10 code E87.2 (Starvation Ketoacidosis) is documented.  Further evaluation and management will be based on patient response to therapy and underlying cause of reduced caloric intake.