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Metabolic Acidosis Ppt

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Dr. Lam describes how the anion gap is calculated in the context of a metabolic acidosis.

5-oxoprolineinduced Anion Gap Metabolic Acidosis After An Acute Acetaminophen Overdose | The Journal Of The American Osteopathic Association

5-OxoprolineInduced Anion Gap Metabolic Acidosis After an Acute Acetaminophen Overdose David T. Lawrence, DO ; Laura K. Bechtel, PhD ; Nathan P. Charlton, MD ; Christopher P. Holstege, MD From the Division of Medical Toxicology and the Department of Emergency Medicine at the University of Virginia School of Medicine in Charlottesville, Virginia. Address correspondence to Nathan P. Charlton, MD, Division of Medical Toxicology, University of Virginia School of Medicine, P.O. Box 800774, Charlottesville, VA 22908-0774. E-mail: [email protected] Cardiovascular Disorders / Emergency Medicine / Gastroenterology / Hypertension/Kidney Disease / Neuromusculoskeletal Disorders / Obstetrics and Gynecology / Psychiatry 5-OxoprolineInduced Anion Gap Metabolic Acidosis After an Acute Acetaminophen Overdose The Journal of the American Osteopathic Association, September 2010, Vol. 110, 545-551. doi:10.7556/jaoa.2010.110.9.545 The Journal of the American Osteopathic Association, September 2010, Vol. 110, 545-551. doi:10.7556/jaoa.2010.110.9.545 Lawrence DT, Bechtel LK, Charlton NP, Holstege CP. 5-OxoprolineInduced Anion Gap Metabolic Acidosis After an Acute Acetaminophen Overdose. J Am Osteopath Continue reading >>

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Popular Questions

  1. bookyeti

    Hello, Keto veterans out there! How do I know if I'm in ketosis? I know it's not overly necessary to know, but I'm curious.
    I've been sticking to Keto faithfully for 5 days now, keeping my macros at 5%C-25%P-70%F. I've never been over 20g of net carbs since I started, and I have been hitting my 70-75% fat macro almost perfectly.
    I have read about the "ketosis" signs to look for ('fruity' breath, different smell to urine, metalic taste in the mouth, more energy), but I haven't noticed any of these. The only thing is that I lost 2 lbs. overnight. I also haven't been experiencing the dreaded "carb flu" that everyone talks about, but that may be because I've been keeping my fat intake quite high (70-75%) and drinking plenty of water (10-12 glasses at least). Also in the past month I have been reducing my carbs gradually down to about 100-125g/day, until I started keto five days ago.
    Is there anyway to know for sure?
    (Unfortunately, I don't have any Keto strips, at the moment - they don't sell them near here, so I had to order them online. They're in the mail.)

  2. RiesigJay

    My personal glucose-to-ketones transition may be unique, but I remember sitting at the dining room table, doing homework on my laptop, when I got the sudden urge to go for a run or exercise or something.
    I ended up cleaning up the whole apartment (at the time I was attending college and had 4 housemates - I'm sure you can imagine how messy it was). I literally could not continue sitting and clacking away at the keyboard. I had to move.
    That was my transition and I knew, without a doubt, I had entered ketosis. Perhaps your experience will be similar.

  3. albertabeefy

    Hello, Keto veterans out there! How do I know if I'm in ketosis? I know it's not overly necessary to know, but I'm curious.
    I've been sticking to Keto faithfully for 5 days now, keeping my macros at 5%C-25%P-70%F. I've never been over 20g of net carbs since I started, and I have been hitting my 70-75% fat macro almost perfectly. It would be virtually impossible to NOT be in ketosis at this point. You're well on your way to being fully keto-adapted.
    I have read about the "ketosis" signs to look for ('fruity' breath, different smell to urine, metalic taste in the mouth, more energy), but I haven't noticed any of these. Many people do NOT experience those. Those are signs during the initial entry into ketosis usually experienced by someone who's done a much-more drastic dietary change than you've done.
    If you're used to eating 50-60% carbs, then go into ketosis, you'll likely experience some or all of those symptoms for a day or two, sometimes more. For someone that's reduced carbohydrate more gradually, and is already relatively low-carb, the shift is often asymptomatic.
    The only thing is that I lost 2 lbs. overnight. I also haven't been experiencing the dreaded "carb flu" that everyone talks about, but that may be because I've been keeping my fat intake quite high (70-75%) and drinking plenty of water (10-12 glasses at least). Also in the past month I have been reducing my carbs gradually down to about 100-125g/day, until I started keto five days ago. The weight-loss is likely a result of lost water/glycogen as you push further into keto-adaptation. Because you were already quite low-carb, you'll likely not experience the 'keto-flu' or other symptoms.
    Is there anyway to know for sure?
    (Unfortunately, I don't have any Keto strips, at the moment - they don't sell them near here, so I had to order them online. They're in the mail.) Ketostix sometimes don't even register, especially for those of us that stay well-hydrated. If you test on a day when your water intake is lower, you'll most definitely get a pink result. Purple would mean you're very dehydrated ...
    If you've already been under 100g and at a reasonable caloric intake, it's also quite possible you already WERE in ketosis and didn't know it. Many people mistakenly think you need to eat 20-30g to be in ketosis, and that's not necessarily the case.
    It's easier to GET ketogenic starting at 20-30g a day, and some find best glycemic control, etc., at very low levels, but most people eating 2000+ calories a day can easily maintain ketosis/keto-adaptation at 100g a day of carbohydrate if they're not sedentary.
    As an anecdotal example, for me to get OUT of ketosis takes 2-3 full SEDENTARY days of 150g + carbohydrate intake. There are some people that think I'm not ketogenic at 50 or 70g of carbohydrate a day . . . they're simply misinformed.
    Lyle McDonald - a leading expert on ketogenic diets - states:
    "Since many books give the 30 g/day value for a ketogenic diet, folks get a little anxious about carb intakes that are higher than that.
    However, strictly speaking, any diet with less than 100 g/day of carbohydrate will cause ketosis to develop to some degree (more ketones will be generated as carbs are lowered)." Those who engage in exercise, especially strength-training, can often eat a little more than others without issue. Lyle did some calculations (rough, by his own admission) and states:
    "The carbohydrate requirements for weight training actually aren’t that great. I did some rough calculations in The Ketogenic Diet and concluded that, for every 2 work sets (assuming a set length of 30-45 seconds) or so, you’ll need 5 grams of carbohydrates to replenish the glycogen used.
    So if you did a workout containing 24 work sets, you’d only need about 60 extra grams (24 sets * 5 grams/2 sets = 60 grams) of carbohydrate to replace the glycogen used." 24 sets is 4 sets of six exercises ... which is a fairly heavy day for many of us. I typically do 5 sets of 4 exercises every-other-day. This would be 20*5/2 = 50g ... however I'm a little larger than most so I'll typically have 50, 70 even 90g of carbohydrate on my strength-training days, depending on the effort.
    So, what I'm saying is if you were exercising, especially doing strength-training or any anaerobic interval training, etc., while eating 100-125g of carbohydrate a day, you were quite-possibly already IN ketosis . . .

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

Metabolic Acidosis In The Newborn | Neonatology: Clinical Practice And Procedures | Accesspediatrics | Mcgraw-hill Medical

Metabolic acidosis in the neonate can be caused by several reasons, including increased acid intake from exogenous sources; increased endogenous production of an acid, such as seen in an inborn error of metabolism (IEM); inadequate excretion of acid by the kidneys; or excessive loss of bicarbonate in urine or stool. Presence or absence of an anion gap (AG) can help to distinguish the underlying etiology. In general, with a pure or uncompensated metabolic acidosis, every 10 mEq/L fall in bicarbonate (HCO3) results in an average pH fall of 0.15. Neonates have an average arterial pH of 7.37 (range of 7.357.45). The average bicarbonate level in a neonate is 20 mEq/L. A diagnosis of metabolic acidosis can be made when the pH is less than 7.35 and a base deficit greater than 5 exists. 1 The AG is calculated by subtracting the serum concentrations of the measured anions (bicarbonate and chloride) from the cation sodium ( Figure 60-1 ). The AG equation can be written as AG = ([Na+]) ([Cl] + [HCO3]). A normal AG is typically less than 12 mEq/L. 1 If the AG is elevated (ie, > 15 mEq/L), then there are anions that have not been accounted for, and an investigation must be performed to search Continue reading >>

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Popular Questions

  1. Emacfarland

    I'm confused about what defines being in nutritional ketosis based on blood levels. The Diet Doctor website says 1.5 is considered ketosis while I've heard on Keto Talk from Doc Nally that fit and active people can be in ketosis at levels of .3 or .4 and that higher levels don't necessarily mean better. So I'm not sure what the heck I'm aiming for! If I get readings below 1.5 am I doing something wrong? I am fit and active and Doc Nally has said this can make blood ketone level readings lower because an active persons body is using the ketones more efficiently. Should I be aiming for higher levels?

  2. BillJay

    It seems that the longer someone is keto-adapted, the more their body produces just the right amount of ketones and what we measure in the blood is only what's not actually being used, therefore it seems not only possible, but likely that people are in ketosis even with lower betahydroxybutyrate (BHB) levels - the ketone in the blood that these meters measure.
    This is somewhat frustrating for me since I'd like for there to be an objective measurement of being in ketosis, but that seems to be elusive.
    Therefore, a better indication is your level of carbs since it is HIGHLY unlikely that anything over 50 carbs is in ketosis and more likely that keeping carbs under 20 grams is a safe bet. Another indication is keeping protein at moderate levels which is 1.0 to 1.5 grams per kilogram of lean body weight.
    Once the macro-nutrients are in the proper range, I think that signs of keto-adapation are more poignant and below is a post from Mark Sisson on Dr. Mercola's site that explains many of the signs of being keto-adapted.

    What Does It Mean to Be Fat Adapted?
    543

  3. richard

    Dr Phinney invented the term so he gets to define it.
    In his book "The art and science of low carbohydrate living" he gives the range from 0.5 to 3.0 mmol/l
    But recently he mentioned that some of Dr Volek's very athletic subjects were clearly in ketosis at 0.2 mmol/l.
    My personal range is from 0.2 to 0.8 mmol/l, and I have been in ketosis for almost 3 years. Prof Tim Noakes is also normally in the same range 0.2-0.8.
    I suspect when we first start we aren't good at using them so we make too many and use too little so we end up with a lot left in our blood. After we become better adapted we end up in whatever physiological range our bodys feel best ensures our survival. And people who are trained and good fat burners may be able to get away with less because they can make it easily.
    When I fast for 3 days and then do 3 hours of exercise my ketones can go as high as 3.5. But I know people who regularly get up to 7.
    It's worth pointing out that Dr Nally has mentioned in his most recent podcast that he eats exogenous ketones 3 times a day. And he sells them.

    Personally I wouldn't be worried. I think you are doing fine.

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What is ALKALOSIS? What does ALKALOSIS mean? ALKALOSIS meaning - ALKALOSIS pronunciation - ALKALOSIS definition - ALKALOSIS explanation - How to pronounce ALKALOSIS? Source: Wikipedia.org article, adapted under https://creativecommons.org/licenses/... license. SUBSCRIBE to our Google Earth flights channel - https://www.youtube.com/channel/UC6Uu... Alkalosis is the result of a process reducing hydrogen ion concentration of arterial blood plasma (alkalemia). In contrast to acidemia (serum pH 7.35 or lower), alkalemia occurs when the serum pH is higher than normal (7.45 or higher). Alkalosis is usually divided into the categories of respiratory alkalosis and metabolic alkalosis or a combined respiratory/metabolic alkalosis. Respiratory alkalosis is caused by hyperventilation, resulting in a loss of carbon dioxide. Compensatory mechanisms for this would include increased dissociation of the carbonic acid buffering intermediate into hydrogen ions, and the related excretion of bicarbonate, both of which lower blood pH. Hyperventilation-induced alkalosis can be seen in several deadly central nervous system diseases such as strokes or Rett syndrome. Metabolic alkalosis can be caused by rep

Metabolic Acidosis & Metabolic Alkalosis

Published by Lambert Morgan Modified over 2 years ago Presentation on theme: "Metabolic acidosis & Metabolic alkalosis" Presentation transcript: 1 Metabolic acidosis & Metabolic alkalosis 3 Primary Change Secondary change Net effect Hco3 Pco2 pH ( H+) Pco2 should by 1.2 mmHg for each mEq plasma Hco3 Inability to excrete dietary acid load Renal failure Renal tubular acidosis type 1 &4 Increased H+ load Lactic acidosis Ketoacidosis Toxin ingestions Increased HCO3 loss diarrhoea 5 Normal anion gap or hyper chloremic acidosis AG = Na+ (Hco3 + Cl ) Normal = 12 4 ( 8 16 ) Measure of unmeasured anion (protiens) Normal anion gap or hyper chloremic acidosis High anion gap 6 Metabolic acidosis Lactic acidosis Ketoacidosis Diarrhoea High anion gap Normal anion gap Lactic acidosis Ketoacidosis Renal failure Toxin ingestions Salicylate Methanol Ethylene glycol Diarrhoea Renal tubular acidosis 7 Clinical features Kussmals respiration (increased depth than rate) Neurologic symptoms: lethargy to coma In severe acidosis (pH< 7.1): Cardiac arrhythmia Reduced cardiac contractility Decreased inotropic response to catecholamines. Chronic acidosis Impaired growth in children Osteomalacia/osteopenia 8 T Continue reading >>

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Popular Questions

  1. warriorscholar

    Hey all,
    I need to be to work in 6 hours and I can't seem to fall asleep. Anyone else get insomnia real bad when ketosis kicks in hard?
    Cheers,

  2. DeltaSierra

    That's funny because I normally have terrible insomnia when I'm *not* in ketosis - I sleep much better when I am. I guess it affects everybody so differently - like some people go into "induction sickness" but that never bothered me. I hope you are able to deal with it - incidently have you ever tried melatonin? I swear by it for those nights when, regardless what my diet is, I simply can't sleep.

  3. warriorscholar

    I used to take melatonin back in the day. I never noticed an effect. I guess it couldn't hurt to give it a shot. I suppose I've always had sleeping trouble. I should look into this.
    Cheers,

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