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Pathophysiology Of Metabolic Acidosis

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

Metabolic Acidosis In Emergency Medicine

Author: Antonia Quinn, DO; Chief Editor: Romesh Khardori, MD, PhD, FACP more... Metabolic acidosis is a clinical disturbance characterized by an increase in plasma acidity. Metabolic acidosis should be considered a sign of an underlying disease process. Identification of this underlying condition is essential to initiate appropriate therapy. This article discusses the differential diagnosis of metabolic acidosis and presents a scheme for identifying the underlying cause of acidosis by using laboratory tests that are available in the emergency department. Clinical strategies for treating metabolic acidosis are also reviewed. There are 3 approaches to understanding acid/base balance: A qualitative approach using the Henderson/Hasselbalch equation, a semiqualitative approach with base excess, and the Strong Ion Theory. The 3 theories are reviewed below. Henderson-Hasselbalch approach to acid/base physiology The Henderson-Hasselbalch equation describes the relationship between blood pH and the components of the H2 CO3 buffering system. This qualitative description of acid/base physiology allows the metabolic component to be separated from the respiratory components of acid/base balanc Continue reading >>

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  1. jim55

    ketone meter

    I'm contemplating buying a precision ketone meter. I've been thinking about it for some time, but just didn't want another gadget to deal with. Walmart has one for 18 buck plus cost of strips.
    How often do people test and at what time of day gives best info.
    Thanks,
    jim---_

  2. petrowizard

    Just out of curiousity, how much are the strips at Walmart?

  3. jim55

    From what i've read there expensive at just under 20 bucks for ten strips. Definantly don't want to waist them!

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Pathogenesis Of Metabolic Acidosis With Hypoxia

Pathogenesis of Metabolic Acidosis with Hypoxia Part of the Clinical Physiology Series book series (CLINPHY) Metabolic acidosis is broadly defined as a condition characterized by an arterial pH below 7.35 in the absence of hypercapnia. There are several varieties of metabolic acidosis, and one method of classification is on the basis of the anion gap. The anion gap (AG) is defined as the difference between the blood concentration of sodium (Na) minus those of chloride (Cl) and bicarbonate (HCO3) (39,69). Thus, metabolic acidosis can be classified according to whether the AG is normal, low, or elevated. Increased AG metabolic acidosis includes those disorders of acidbase metabolism where there is acidosis because of the presence of increased quantities of organic acid(s). Such organic acids may be either endogenous (keto acids, lactic acid) or exogenous (salicylate, paraldehyde). Those forms of metabolic acidosis with normal to low AG are primarily the renal tubular acidoses, which are not discussed in this chapter. In equation form, the AG can be defined as in equation 1, below. Metabolic AcidosisLactic AcidosisLactate ProductionTissue HypoxiaLactic Acid Production These keywords Continue reading >>

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  1. kryptomancer

    Experienced fasters: How long does it take you to reach ketosis?

    It seems that it takes about 3 days for the average person to get into a state of ketosis when fasting.
    For those of you who are veterans of fasting, especially longer fasts (5+ days), how long does it take you to get into ketosis?
    I'm curious about this due to this guy going into ketosis in only 2 days on his second 5 day fast. Was wondering if it was due to the avocado or his body just adapting faster.

  2. Glarsie

    You should be in ketosis once your liver glycogen stores are depleted. In a fast this should occur in 24-48hrs after your last meal and will be influenced by your insulin sensitivity (which affects you basal insulin level) and the amount of glycogen in your liver (ie what you ate leading up to the fast). It's entirely possible (some would argue desirable) to be in ketosis before fasting. Nutritional ketosis generally starts when you have a betahydroxybuterate level greater than .5 mmol/L which can't be accurately measured through urine ketostix which only show excreted acetoacetate (not blood concentrations of BHB). You can turn those keto sticks dark purple just by restricting fluid intake and becoming slightly dehydrated or equally make them not register by drinking half a gallon of water.
    Ketosis is brought on by a lack of carbohydrates/insulin and not by the presence of fat.
    Eat under 20g of net carbs per day (don't count fibre) for 3 days and you will be in ketosis. You will probably be in ketosis sooner, but 3 days is pretty true for everyone.
    Remember that as you produce ketones you will start to use them as well as free fatty acids for fuel (less is excreted in urine and blood levels don't increase indefinitely). In the end ketones will be used primarily for your brain and other tissues not able to use FFA while glucose will be reserved for cells that can only use glucose (eg red blood cells and some parts of the brain). The breakdown of triglycerides into FFAs also releases glycerol that is converted into glucose to supply the now reduced demand for glucose. This doesn't happen as soon as you produce ketones but over a few days as your levels increase.
    Edit: nutritional ketosis defined as starting at .5 rather than .3 mmol/l

  3. kryptomancer

    this should occur in 24-48hrs after your last meal
    Actually in the link I posted it took 3 days initially for the guy to go into ketosis, then on the second time through it only took him 2. I'm very interested in to why this was as I am planning on doing a series of longer fasts and want to make it as easy as possible.
    and will be influenced by your insulin sensitivity
    So perhaps the reason why the 2nd fast was quicker to get into ketosis with due to increased insulin sensitivity from his initial fast?
    and the amount of glycogen in your liver (ie what you ate leading up to the fast).
    This is my current plan: eat under 20g carbs for two days, start water fasting on the third and lifting heavy squats and dead lifts; then taking apple cider vinegar before bed.

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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

Acidosis And Alkalosis Pathophysiology

This video is to help understand the difference between Acidosis and Alkalosis. Acidosis is excessive blood acidity caused by an overabundance of acid in the blood or a loss of bicarbonate from the blood (metabolic acidosis), or by a buildup of carbon dioxide in the blood that results from poor lung function or slow breathing (respiratory acidosis). Blood acidity increases when people ingest substances that contain or produce acid or when the lungs do not expel enough carbon dioxide. People with metabolic acidosis have nausea, vomiting, and fatigue and may breathe faster and deeper than normal. People with respiratory acidosis have headache and confusion, and breathing may appear shallow, slow, or both. Tests on blood samples show there is too much acid. If an increase in acid overwhelms the bodys pH buffering systems, the blood will become acidic. As blood pH drops, the parts of the brain that regulate breathing are stimulated to produce faster and deeper breathing. Breathing faster and deeper increases the amount of carbon dioxide exhaled. The kidneys also try to compensate by excreting more acid in the urine. However, both mechanisms can be overwhelmed if the body continues to Continue reading >>

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  1. Modernpreacher

    I've not seen a lot of discussions on the why this happens. There are days where I barely get hungry all day, and others when I am ravenous.
    Curious if anyone has studied what physiological effect of the Ketogenic lifestyle causes the hunger decreases. I've read about the various hormones that cause satiety, but that doesn't strike me as the same thing.
    I was reading in one site, that it has to do with adrenaline release, but I would have thought that would lead to increased heart rate, inability to sleep, etc. And none of those factors seem to occur.
    So... smart people. Why aren't we hungry?

  2. Naonin

    I've read a ton of literature on it and frankly if you're looking for that exact physiological mechanism that creates satiety on keto, we don't know yet.
    It may be a mix of 10 small things, carbohydrate restriction, protein increase, eating more solid foods instead of liquid calories, fiber increase, hormonal changes, rate of digestion, getting "the right fuel", etc.
    But when it comes down to it, the literature hasn't proven if keto is more satiating than other diets. We experience better satiety generally, but it could be either one thing per person (such as glycine stimulating GLP1) or something else in another person altogether (such as sleep correction).
    It's very odd that it works so well for so many people simply by changing two or three large things: reducing carbs, increasing fat, slightly increasing protein. These many be the satiating things but really I haven't seen a decent explanation of why. Just that it happens.

  3. causalcorrelation

    this is not necessarily a literature-based explanation, but if you haven't tried fasting while in ketosis (and I mean, literally, go and eat nothing for 40 hours) you'll be surprised by the results.
    I think it has a lot to do with the fact that starvation and ketosis share some of the same physiological adaptations. Someone eating an ordinary diet has to go through "carb withdrawals" or "keto flu" (I still can't agree on a good name for this thing...) when trying to fast, and part of that is miserable hunger. Those of us in ketosis already get to skip that step.

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