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Metabolic Acidosis Ppt

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

Increased Anion Gap Metabolic Acidosis As A Result Of 5-oxoproline (pyroglutamic Acid): A Role For Acetaminophen

Increased Anion Gap Metabolic Acidosis as a Result of 5-Oxoproline (Pyroglutamic Acid): A Role for Acetaminophen *Department of Internal Medicine; Metabolic Disease Center, BRI Baylor University Medical Center, Dallas, Texas Dr. Andrew Z. Fenves, Nephrology Division, Baylor University Medical Center, 3500 Gaston, Dallas, TX 75246. Phone: 214-820-2350; Fax: 214-820-7367; E-mail: fenvesa{at}dneph.com The endogenous organic acid metabolic acidoses that occur commonly in adults include lactic acidosis; ketoacidosis; acidosis that results from the ingestion of toxic substances such as methanol, ethylene glycol, or paraldehyde; and a component of the acidosis of kidney failure. Another rare but underdiagnosed cause of severe, high anion gap metabolic acidosis in adults is that due to accumulation of 5-oxoproline (pyroglutamic acid). Reported are four patients with this syndrome, and reviewed are 18 adult patients who were reported previously in the literature. Twenty-one patients had major exposure to acetaminophen (one only acute exposure). Eighteen (82%) of the 22 patients were women. Most of the patients were malnourished as a result of multiple medical comorbidities, and most had so Continue reading >>

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  1. Bekky1975

    Just out of hospital following DKA

    Hi
    I'm off work following recovery from recent keto-acidosis. Been T1 diagnosed for nearly 5 years but really struggle to accept my illness. Try and pretend I don't have Diabetes. Did anyone else out there have this problem? What will it take to get out of this denial? I'm 31 and thought I would be more sensible!!!

  2. vrocco1

    I'm very sorry you had that experience. How did you end up DKA? I'm guessing you skipped a dose of insulin?
    It has only happened to me once, and that was during a month long bout with the flu. I really learned my lesson on that one. Keeping your A1C low is a lot of effort, but keeping yourself out of the hospital does not take much effort at all.
    You may be suffering from a bit of depression, and that is why you are in denial. You might want to talk to your Doctor about that possibility. Denial is definitely our enemy. Depression is very common in diabetics.
    I hope you decide to spend some time with us. It really can help! I sure hope you feel better soon.

  3. Jodes800

    Hi Bekky,
    I totally understand what you're going through! I was daignosed at 10 but had a couple of years when I was a teenager that I went into denial. I would still have my injections but would eat whatever I liked!
    I soon realised that this way of thinking was doing me no good and that I had to deal with it or go on feeling ill for the rest of my life so I started taking better care of myself. I also thought about the complications that could arise in the future and what that could mean for me...for example would I be able to have the family that I have always dreamed of?
    I have been in and out of hospital on many occassions with Ketoacidosis, due to viruses and stomach bugs etc, but the doctors never told me what it was! I didn't know anything about Ketoacidosis and because of this i had a really severe Ketoacidosis incident when I was 18. I was at university and was feeling progressively more unwell...I went to A & E where doctors failed to do any blood or urine samples and diagnosed me with anxiety! I also called another doctor out that night who gave me a sleeping tablet and left me in my room alone and with no medical assistance...I was found the next morning minutes from death..and was in Intensive care for a week.
    I totally understand how you must be feeling at the moment as it takes away all your energy and takes a while for you to start feeling stronger. The Ketoacidosis won't cause any long term damage to your health but you should be aware that not taking care of your diabetes or having an illness of any kind can cause Ketoacidosis. More often than not it is treated quickly and efficiently by the medical proffessionals but sometimes it isn't-like in my case-so always check for ketones if you start to feel unwell or your blood sugars run high.
    You won't be in denial forever..diabetes takes a long time to understand and come to terms with....at 10 years old I think it may have been easier for me to accept than for someone diagnosed in their 20's...but I still found it incredibly hard!
    You've done the right thing joining this site as there are so many great people out there to talk to and for the first time since my diagnosis 15 years ago I feel like I can offload my fears and anxieties and also share good news with people who can empathise with what I'm going through...We're all here to help and anytime you feel down tell us about it and we'll try to help! We all understand how you're feeling!
    Big hugs!

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A lecture on the differential diagnosis of a normal anion gap metabolic acidosis, focusing on renal tubular acidosis, but also covering diarrhea, saline infusion, hyperkalemia, kidney failure, and ureteral diversion

Normal Anion Gap Metabolic Acidosis

Home | Critical Care Compendium | Normal Anion Gap Metabolic Acidosis Normal Anion Gap Metabolic Acidosis (NAGMA) HCO3 loss and replaced with Cl- -> anion gap normal if hyponatraemia is present the plasma [Cl-] may be normal despite the presence of a normal anion gap acidosis -> this could be considered a ‘relative hyperchloraemia’. Extras – RTA, ingestion of oral acidifying salts, recovery phase of DKA loss of bicarbonate with chloride replacement -> hyperchloraemic acidosis secretions into the large and small bowel are mostly alkaline with a bicarbonate level higher than that in plasma. some typical at risk clinical situations are: external drainage of pancreatic or biliary secretions (eg fistulas) this should be easily established by history normally 85% of filtered bicarbonate is reabsorbed in the proximal tubule and the remaining 15% is reabsorbed in the rest of the tubule in patients receiving acetazolamide (or other carbonic anhydrase inhibitors), proximal reabsorption of bicarbonate is decreased resulting in increased distal delivery and HCO3- appears in urine this results in a hyperchloraemic metabolic acidosis and is essentially a form of proximal renal tubular aci Continue reading >>

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  1. DavezWife

    what were/are your bowel habits and stools like when you're on it?
    I've always had the "met schizzles", or so I thought. A pretty sudden urgency to go, and kinda explosive loose stools when I do. Floaties, small chunks if any. light to medium brown.
    Well, now that I've gone gluten & dairy free (as an experiment on my auto-immune stuff) I've not had those BM's, and they're less, dark, more compact and sink. (lol)
    I'm reading about Celiac Disease (related to the AI stuff and gluten allergies) and darnit to heck if I don't see this:
    people with CD have increased amounts of fat in the stool (steatorrhea). The unabsorbed fat is broken down by intestinal bacteria into fatty acids, and these fatty acids promote secretion of water into the intestine, resulting in diarrhea. Fatty stools typically are large in volume, malodorous (foul smelling), greasy, light tan or light grey in color, and tend to float in the toilet bowl. Oil droplets (undigested fat) also may be seen floating on top of the water.
    That just is too familiar. BUT I've changed my diet. (and stayed on the met) So who knows. But I guess I'm curious if my met schizzles sound like other's met schizzles. lol.
    I'll do a courtesy flush on this post later. (aka DD, ha)

  2. KellyOsu23

    I am lurking today,
    But I will chime in, HI Davez!! Nice to see ya
    I am not on Metformin right now, because I was having major issues as you described.
    Sometimes really severe lime 30 seconds to get to the toilet or blow warning
    But I also thought perhaps, it was Gallbladder related since I had that out right after Ashlyn too.
    Needless to say, I stopped Metformin and I still have the "metformin" attacks perhaps 2-3 times a week. Usually after eating a meal out or the morning after eating a meal out.
    So perhaps its Diet related, or perhaps Gallbladder I am not sure. But I am interested in hearing what the other ladies say.

  3. KellyOsu23

    OH and I loved your little Red Riding hood video! Its too cute! What program do you use for editing your videos/putting them together etc?

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https://www.facebook.com/drinkhealthy... - Do you want to learn how to get rid of lactic acid as an athlete, and start recovering quicker with more energy? Learn how to reduce lactic acid symptoms and increase your performance. Getting rid of lactic acid may be easier than you have imagined. Many professional athletes know the importance of eliminating lactic acid so they can recover quicker and perform at an optimal level. Start flushing out that lactic acid today! Many people suffer from lactic acidosis symptoms and are rigorously searching for a lactic acid treatment. More and more athletes are searching for solutions on how to get rid of lactic acid. In this video you will learn what a professional football player from the Seattle Seahawks is using to eliminate lactic acid after his workouts, practices, and NFL games. Learn how to make lactic acid a symptom of the past. Begin your journey to faster recovery today. See what the pro's are using to reduce lactic acid, recover quicker, and have more energy. Uncertain of what lactic is? Here is the definition https://en.wikipedia.org/wiki/Lactic_... Contact me for more information on getting rid of lactic acid FB: http://www.facebook.com/duncan.fraser... IG: http://www.instagram.com/kangendunc [email protected] See a full demonstration of this solution that helps get rid of lactic acid https://www.youtube.com/watch?v=MTxR9... Duncan Fraser 0:00 - 0:13 - Introduction 0:14 - 2:11 - Shan Stratton and Michael Robinson Discuss how to get rid of lactic acid 2:11 - 2:21 - 4 benefits of this incredible technology 2:21 - 2:39 - Conclusion Get in contact with me if you have problems with lactic acid and learn more on my FB page. Visit my Facebook page below. https://www.facebook.com/drinkhealthy...

Lactic Acidosis

Lactic acidosis is a medical condition characterized by the buildup of lactate (especially L-lactate) in the body, which results in an excessively low pH in the bloodstream. It is a form of metabolic acidosis, in which excessive acid accumulates due to a problem with the body's metabolism of lactic acid. Lactic acidosis is typically the result of an underlying acute or chronic medical condition, medication, or poisoning. The symptoms are generally attributable to these underlying causes, but may include nausea, vomiting, rapid deep breathing, and generalised weakness. The diagnosis is made on biochemical analysis of blood (often initially on arterial blood gas samples), and once confirmed, generally prompts an investigation to establish the underlying cause to treat the acidosis. In some situations, hemofiltration (purification of the blood) is temporarily required. In rare chronic forms of lactic acidosis caused by mitochondrial disease, a specific diet or dichloroacetate may be used. The prognosis of lactic acidosis depends largely on the underlying cause; in some situations (such as severe infections), it indicates an increased risk of death. Classification[edit] The Cohen-Woods Continue reading >>

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  1. Feldew

    I have a friend who's three month's pregnant and I mentioned keto to her, but we weren't sure if it would be safe to go into ketosis when you're already pregnant. I figure it can't be too bad to be in ketosis and then get pregnant, but her already being pregnant makes me a bit hesitant to suggest it until the baby is born.

  2. sellyberry

    Keto is safe if you do it safely? Drink lots of water, get electrolytes, eat when you are hungry.
    Depending on start weight, if she is obese and her doctors told her to try to not gain a lot, then it's fine. I wouldn't recommend any diet to someone of normal weight who just doesn't want to get fat. Gaining weight is a very important part of growing and eventually feeding a healthy baby.
    I was keto when I conceive both my kids but because of cravings I wasn't able to maintain the diet. Postpartum it took me 6 months with the first and 4 months with the second to get back into keto and once I did I lost (am losing) the weight pretty easily.
    If she's diabetic or has other medical issues it's questionable to start while pregnant.

  3. Feldew

    She's of normal weight, no issues that I know of, she did say she's having trouble eating as many calories as she's told to every day.

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