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Metabolic Acidosis Symptoms

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

Metabolic Acidosis: Pathophysiology, Diagnosis And Management

Jeffrey A. Kraut, MD is Chief of Dialysis in the Division of Nephrology at the Greater Los Angeles Veterans Administration Healthcare System, Professor of Medicine at the David Geffen School of Medicine at UCLA, and an investigator at the UCLA Membrane Biology Laboratory, Los Angeles, CA, USA. He completed his nephrology training at the TuftsNew England Medical Center where he performed basic research examining the mechanisms regulating acid excretion by the kidney. His present research is focused on delineating the mechanisms contributing to cellular damage with various acidbase disturbances, including metabolic acidosis, with the goal of developing newer treatment strategies. Nicolaos E. Madias, MD is Chairman of the Department of Medicine at St. Elizabeth's Medical Center in Boston, and Maurice S. Segal, MD Professor of Medicine at Tufts University School of Medicine, Boston, MA, USA. He completed his nephrology training at TuftsNew England Medical Center. He has previously served as Chief of the Division of Nephrology at TuftsNew England Medical Center, Established Investigator of the American Heart Association, member of the Internal Medicine and Nephrology Boards of the Amer Continue reading >>

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  1. just hopping!

    RE: Bad Breath and Running

    Why do you think it's from running?

  2. Brent

    RE: Bad Breath and Running

    Two possibilities, both of which can be related to your running:
    1. Dehydration. If you are dehydrated, your breath can stink.
    2. Ketosis. This is the condition you get if you follow one of those low-carb, high-protein diets. One of the side-effects of ketosis is bad body odor and bad breath. Are you cutting down on your carbs? Are you dieting? Are you eating lots of meat while shying away from grains, fruits, and vegatables? The effects of a low-carb diet (including bad breath) are going to be magnified if you're exercising.
    So, drink lots of water and eat some carbs.

  3. runnerchick

    RE: Bad Breath and Running

    do you brush your teeth regularly, floss and use mouthwash? flossing often helps a lot.

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In this video, I review the basics of evaluating and managing acute post-operative metabolic acidosis. All patients with acute or worsening metabolic acidosis should be aggressively evaluated. The etiology of acute metabolic acidosis in this population is frequently an anion gap metabolic acidosis on the basis of global hypoperfusion or local production of lactic acid (eg. bowel or lower extremity). I discuss the current thinking on bicarbonate replacement therapy as well as respiratory assessment and ventilator management in patients with acute metabolic acidosis.

Evaluation Of Metabolic Acidosis

The presence of metabolic acidosis is a clue to the possible existence of several underlying medical conditions. Arterial pH <7.35 defines acidosis. Metabolic acidosis is indicated by a decrease in the plasma bicarbonate level and/or a marked increase in the serum anion gap (AG). Metabolic acidosis may occur due to the following reasons: Addition of strong acid that is buffered by and consumes bicarbonate ion Loss of bicarbonate ion from the body fluids, usually through the GI tract or kidneys Rapid addition to the extracellular fluid of a nonbicarbonate solution. Differentiating between the causes of metabolic acidosis begins with calculation of serum AG. Serum AG is calculated by subtracting the sum of major measured anions, chloride (Cl) and bicarbonate (HCO3), from the major measured cation, sodium (Na+). Normal serum AG is due to the difference between unmeasured anions such as sulfate (SO4), phosphate (PO4), albumin, and organic anions, and unmeasured cations such as potassium (K+), magnesium (Mg+), and calcium (Ca2+). Plasma proteins also play a role in maintaining normal serum AG. [1] Dubin A, Menises MM, Masevicius FD, et al. Comparison of three different methods of evalu Continue reading >>

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  1. ab.er.rant

    I just came back from a series of test to check my heart palpitations. The doctor didn't see anything obvious that could directly cause palpitations, so the implication seems to be that it's more related to my diet change (been a month since I started moderate low-carb) and bodily adjustments.
    My blood test came back a bit high on uric acid, and the doctor said a low-carb diet has a tendency to cause it. So essentially I'm told that I'm at a risk of developing high blood pressure. I wasn't diagnosed as having gout since I have no joint problems. The doctor also suggested that I could simply be not eating enough, causing elevated levels.
    Anyone has a similar experience? It seems that I should eat less meat and more veges.

  2. muzza3

    Hi @ab.er.rant
    Can't help personally but was interested so had a look. This seemed credible and had some suggestions.
    http://www.naturalremedies.org/uric-acid/
    Cheers

  3. chri5

    ab.er.rant said: ↑
    I just came back from a series of test to check my heart palpitations. The doctor didn't see anything obvious that could directly cause palpitations, so the implication seems to be that it's more related to my diet change (been a month since I started moderate low-carb) and bodily adjustments.
    My blood test came back a bit high on uric acid, and the doctor said a low-carb diet has a tendency to cause it. So essentially I'm told that I'm at a risk of developing high blood pressure. I wasn't diagnosed as having gout since I have no joint problems. The doctor also suggested that I could simply be not eating enough, causing elevated levels.
    Anyone has a similar experience? It seems that I should eat less meat and more veges.
    Click to expand... Hi, if I was you I would make sure you are drinking plenty of water as this helps to flush uric acid. I used to be prone to gout attacks but since going lchf I haven`t had one in well over a year so I am a little sceptical of lchf causing high uric acid levels. Best of luck anyway, Chris.

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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. timothyw

    Ketosis & BG

    Has anyone ever made a correlation between their blood sugar numbers and Ketosis? I imagine it would be different for everyone. seems to me that if the BG went down to x then you would switch into ketosis for fuel needs. Too high a BG and you wouldn't be in ketosis. Or am I off track here and it is purely the carb count that matters? I have read how atkins suggested increasing carbs each week to find the right level of carbs to maintain weight on his diet.
    Any ideas or thoughts?

  2. MarkM

    You can be in ketosis and have high blood sugar levels but low insulin levels. This what happens to T1s at onset, but it gets worse and there can be ketoacidosis. T2s, if they are insulin resistant and/or insulin deficient, can also be in ketosis and have above normal blood glucose levels.
    Normal people go in and out of ketosis every day. But for someone who has normal insulin production and insulin sensitivity, sustained ketosis would only occur if carb consumption dropped below what is needed to satisfy the normal daily glucose requirement. Some say this is 130 grams of carb a day. Low carbers will tell you it is a lot lower, based on their observations of ketone test results and eating patterns.
    That is my take on it anyway. And in answer to your question, no, I don't think there is a clear correlation there.

  3. Nicoletti

    I never gave it a thought. My concern is keeping blood sugar down.

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