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Metabolic Acidosis

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Anion gap usmle - anion gap metabolic acidosis normal anion gap metabolic acidosis

Metabolic Acidosis: Pathophysiology, Diagnosis And Management: Diagnosis Of Metabolic Acidosis

Recommendations for the treatment of acute metabolic acidosis Gunnerson, K. J., Saul, M., He, S. & Kellum, J. Lactate versus non-lactate metabolic acidosis: a retrospective outcome evaluation of critically ill patients. Crit. Care Med. 10, R22-R32 (2006). Eustace, J. A., Astor, B., Muntner, P M., Ikizler, T. A. & Coresh, J. Prevalence of acidosis and inflammation and their association with low serum albumin in chronic kidney disease. Kidney Int. 65, 1031-1040 (2004). Kraut, J. A. & Kurtz, I. Metabolic acidosis of CKD: diagnosis, clinical characteristics, and treatment. Am. J. Kidney Dis. 45, 978-993 (2005). Kalantar-Zadeh, K., Mehrotra, R., Fouque, D. & Kopple, J. D. Metabolic acidosis and malnutrition-inflammation complex syndrome in chronic renal failure. Semin. Dial. 17, 455-465 (2004). Kraut, J. A. & Kurtz, I. Controversies in the treatment of acute metabolic acidosis. NephSAP 5, 1-9 (2006). Cohen, R. M., Feldman, G. M. & Fernandez, P C. The balance of acid base and charge in health and disease. Kidney Int. 52, 287-293 (1997). Rodriguez-Soriano, J. & Vallo, A. Renal tubular acidosis. Pediatr. Nephrol. 4, 268-275 (1990). Wagner, C. A., Devuyst, O., Bourgeois, S. & Mohebbi, N. R Continue reading >>

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  1. lauraj

    Hiya, my son Ryan has had d since 6/08 but today is the first time i have had positive test for large ketones. He has had a bit of a fever for a couple of days and has had mainly high sugars.
    I am really worried tonight as i have never had a positive result like this. He is on Twice daily injections but i have given him a bit of extra Novorapid before bed and just wondered if anybody could help give me a clearer idea of what may happen? Thanks

  2. Lee

    I do not really understand the two shots a day theory, so I cannot helpout much with that - but I urge you to be in contact with your endo team!!!!
    Other then that, push non-carbed liquids - lots of them, and he will need extra insulin to clear up the ketones!

  3. lauraj

    Thanks, i rang them and they said to see how he goes through the night but i am still worried sick. I have been trying to get him to drink loads but he is tired so asleep now. I just hope the rest helps his blood sugar come down

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The Pharmacotherapy Preparatory Review Recertification Course Endocrine and Metabolic Disorders PDF at https://www.mediafire.com/view/8kucuu...

Metabolic Acidosis - Endocrine And Metabolic Disorders - Merck Manuals Professional Edition

(Video) Overview of Acid-Base Maps and Compensatory Mechanisms By James L. Lewis, III, MD, Attending Physician, Brookwood Baptist Health and Saint Vincent’s Ascension Health, Birmingham Metabolic acidosis is primary reduction in bicarbonate (HCO3−), typically with compensatory reduction in carbon dioxide partial pressure (Pco2); pH may be markedly low or slightly subnormal. Metabolic acidoses are categorized as high or normal anion gap based on the presence or absence of unmeasured anions in serum. Causes include accumulation of ketones and lactic acid, renal failure, and drug or toxin ingestion (high anion gap) and GI or renal HCO3− loss (normal anion gap). Symptoms and signs in severe cases include nausea and vomiting, lethargy, and hyperpnea. Diagnosis is clinical and with ABG and serum electrolyte measurement. The cause is treated; IV sodium bicarbonate may be indicated when pH is very low. Metabolic acidosis is acid accumulation due to Increased acid production or acid ingestion Acidemia (arterial pH < 7.35) results when acid load overwhelms respiratory compensation. Causes are classified by their effect on the anion gap (see The Anion Gap and see Table: Causes of Metab Continue reading >>

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  1. tel9

    Hi , I am a 75 year old male with type 2 for around 10 years. I control by diet--no carbs.-- and metformin and glicklaside and my Hb1c tests are in the 6.8 area. I usually blood test twice a day before going driving in the morning and last thing at night before bed time. I have just bought a pack of Bayer Keto- Diastix urine test strips. I do not fully follow as to what colour on the glucose chart I should be aiming for---the very light green end or the mid-range or above. Help needed please ASAP.

  2. GrantGam

    Hello,
    Zero carbohydrates? Wow, that's impressive.
    If you are on a no-carb diet then you may find that you have ketones in your blood due to your body being in a state called nutritional ketosis.
    However, that said - if you BGL runs high then this will only increase your ketone level, and then you run the risk of becoming seriously unwell.
    If it were me, I'd certinaly be aiming to be closer to the negative side of the chart. But I eat carbohydrates and therefore I expect to have a low ketone count.
    Grant

  3. tel9

    GrantGam1337 said: ↑
    Hello,
    Zero carbohydrates? Wow, that's impressive.
    If you are on a no-carb diet then you may find that you have ketones in your blood due to your body being in a state called nutritional ketosis.
    However, that said - if you BGL runs high then this will only increase your ketone level, and then you run the risk of becoming seriously unwell.
    If it were me, I'd certinaly be aiming to be closer to the negative side of the chart. But I eat carbohydrates and therefore I expect to have a low ketone count.
    Grant
    Click to expand... Hi Grant,
    I probably mislead you by saying ''no carbs diet'' I should have said a low carb diet or putting it realistically only potatoes once a week---still love me roast on Sunday, never mind the heat----1 slice brown toast for breakfast and half a roll with my salad daily. frozen veggies with chicken slices some days so I do eat some carbs.
    So I need to be aiming for the left hand side of the scales---the lighter/paler coloured side?.
    I realise that it's not quite like reading your numbers on a blood glucose meter when I was always maybe adjusting my diet to keep around 6.5 on my uk meter if possible and of course there are no corresponding numbers on the scales.
    It's a case of getting used to a different type of testing really.

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Acid/base Disorders: Metabolic Acidosis

Are there clinical practice guidelines to inform decision-making? Does this patient have metabolic acidosis? Metabolic acidosis is generally defined by the presence of a low serum bicarbonate concentration (normal range 22-28 mEq/L), although occasionally states can exist where the serum bicarbonate is normal with an elevated anion gap (e.g., patients with a lactic acidosis who have received a bicarbonate infusion or patients on hemodialysis). In general, a metabolic acidosis is associated with a low urine pH but depending on the presence or absence of a respiratory alkalosis, this may also be normal or elevated. Thus, a patient can have an acidosis but not be acidemic. Metabolic acidoses occur when there is excess acid in the plasma. In the basal state, the body generates about 12,000 to 13,000 mmol of carbon dioxide (CO2), and 1-1.5 mmol per kilogram body weight of nonvolatile acid. The body has a large buffering capacity, with CO2-HCO3 as the major buffer system. The two major routes of acid excretion are the lungs (for CO2) and the kidneys (for nonvolatile acids) A metabolic acidosis can be caused by three major mechanisms: 1) increased acid production; 2) bicarbonate loss; an Continue reading >>

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  1. Eileen

    So much for Atkins and coffee

    Atkins had a theory about coffee kicking you out of ketosis, but I've just been checking my journal, and found that the only time I show measureable ketone traces are the days I'm in town and drinking cups of coffee instead of my usual pots of tea.
    I'm pretty certain I'm in ketosis normally, but all the tea I drink dilutes the ketones too much to measure. Only when I drink coffee (cups instead of pots) do those little sticks turn pink.
    It does seem to make nonsense of Atkin's theory that you have to cut coffee as well as carbs.
    Eileen

  2. Coatsy

    Re: So much for Atkins and coffee

    Originally posted by Eileen
    Atkins had a theory about coffee kicking you out of ketosis, but I've just been checking my journal, and found that the only time I show measureable ketone traces are the days I'm in town and drinking cups of coffee instead of my usual pots of tea.
    I'm pretty certain I'm in ketosis normally, but all the tea I drink dilutes the ketones too much to measure. Only when I drink coffee (cups instead of pots) do those little sticks turn pink.
    It does seem to make nonsense of Atkin's theory that you have to cut coffee as well as carbs.
    Eileen
    Eileen where abouts in Ireland are you from ? Just wondering because I'm not sure where to buy ketostixs to check if im in ketosis or not

  3. Eileen

    Hi, I'm in Dublin, but I know that you can buy Ketostix in Boots with no trouble. They'd probably cost about a fiver for you. Some smaller chemists have them, some don't, and a couple got sniffy about selling them to non-diabetics, claiming they were being "abused" by people on diets.
    Nice to know I'm not alone...
    Eileen

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