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Seizure Lactic Acidosis

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Increased Blood Lactate Indicates Hypoxia Or Circulatory Failure

Lactic acidosis is seen in hypoxia associated with acute cardiac or respiratory failure, shock, and acute blood loss. Blood lactate levels rise very rapidly as oxygen delivery to the peripheral tissues decreases below a critical level.An increased blood lactate level is an earlier indicator of tissue hypoxia than pH.In patients with circulatory shock, mortality increases from 10 to 90% as lactate concentration increases from 2 to 8 meq/L. A sudden increase in oxygen requirement occurs in patients with grand mal seizures and in patients with severe asthma.The increased work of breathing results in release of lactate from the muscles of respiration. Increases in lactate synthesis in the absence of tissue hypoxia may occur when the rate of glucose metabolism exceeds mitochondrial function.Blood lactate levels often increase slowly in patients with lymphoma, leukemia, neoplasms, and sepsis.Increases are usually modest, in the range of 1 to 2 meq/L.Malignant cells have a higher rate of anaerobic glycolysis. Certain drugs and ethanol can also increase blood lactate levels.Phenformin, a biguanide, causes lactic acidosis by increasing both glucose utilization in peripheral tissues and con Continue reading >>

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  1. Shruti Padmanabhan

    Ketosis

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    How does ketosis occur due to low insulin rate?




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    Type 2 diabetes is a condition where the glucose metabolism has gone all awry due to either the body not being able to produce enough insulin or the cells not responding sufficiently to insulin. This condition can result in a host of health complications which can range from mild to life threatening. One such complication is called diabetic ketoacidosis (DKA) and if untreated can lead to coma and death.
    When your body produces little or no insulin, it starts burning fats for fuel. This is because insulin is necessary for pushing glucose (the preferred energy source) inside muscle cells. In the absence of glucose, fats are broken down by cells to derive energy. During this process, acidic substances called ketones are formed which start piling up inside the blood stream. This accumulation leads to ketoacidosis.

    Find out why complications occur in type 2 diabetes in this excellent article.

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Watch more Epilepsy & Seizure Disorders videos: http://www.howcast.com/videos/502007-... Patty McGoldrick NP, MPA: So absence or petit mal seizures as they used to be called are a form of generalized seizures. So again, the whole brain lights up with electricity all at once. They often present in childhood, usually around six to eight years old, maybe a little older, but we've had kids as young as three or four presenting with it. So they look like a sort of eye roll or an eye deviation and a staring spell. Steve Wolf MD: I'll act it for you. So they could be talking to you, and suddenly they'll. . . [pause]. . .What did you say? Patty: Right. And it's more than just your child not paying attention to you. And this goes on repeatedly, and then you realize after a while that they're sort of missing things. And they occur in all situations. They occur watching TV, watching movies. They occur during a conversation. So you have to really weed out and say to the parents when they come in, "Does this only happen when they're watching TV? Or does it only happen in school when the lesson is something they don't understand?" Steve: And there short. They're like three to five seconds sometimes. It can be very easy to miss them. Sometimes the teachers pick them up. But you know, it's hard to differentiate from daydreaming. How do you do that? Patty: Well that's when you bring them in and you do an EEG, because it has a very distinct pattern on the EEG. Steve: But the most important part on the EEG is if you don't capture the episode of the staring spells, then you haven't made the diagnosis. Patty: So on the EEG, there is a pattern that's called 3-hertz spike and wave, and if you look at the EEG you see this big burst of electricity that lasts for a few seconds, and it's across the whole EEG. The problem is that if you do a short EEG for 30 or 40 minutes, you may not get one of these events, and you may not see the abnormality. Because the EEG otherwise is perfectly normal. Steve: But we tell families that this is like one of the better epilepsies, because it has the highest chance of outgrowing it. But if you don't treat it, it really can affect things academically. You worry about kids walking down the block, not you know walking into the street because they'll zone out, falling down the stairs if they zone out. So it's important to treat. Patty: It is important to treat, and it's very important to treat as the kids get older and they're taking subways or buses alone, or they're driving cars, because you don't want them to have an absence seizure or a staring spell in the middle of that. So again, absence seizures are a form of generalized seizures. The electricity lights up in the whole brain all at once. They're short. They can happen many times a day. They may not happen every hour, so they may not be captured on a short EEG. They're very treatable, and it's very important to treat them so a, the child doesn't get hurt, and b, that the child is not missing information in school and doing poorly academically.

Hyperchloremic Acidosis During Grand Mal Seizure Lactic Acidosis

, Volume 20, Issue1 , pp 2731 | Cite as Hyperchloremic acidosis during grand mal seizure lactic acidosis To evaluate the prevalence and the mechanism of hyperchloremic acidosis component (HC1A) during lactic acidosis secondary to grand mal seizures. Medical intensive care unit in a university hospital. 35 patients admitted for grand mal seizures with lactic acidosis (pH<7.35, TCO2 <20 mmol/l and PaCO2 <8 kPa). HC1A was defined by the ratio: excess anion gap/HCO3 deficit (AG/TCO2) <0.8. A difference in the distribution space of protons and their accompanying anion, i.e., a displacement of chloride from cells by the entering lactate, was evaluated by the ratio natremia/chloremia (Na+/Cl). Immediately after seizures, a profound lactic acidosis was observed (pH=7.220.17 (meanSD), AG: 23.87.1 mmol/l, TCO2=14.55.3 mmol/l, lactate: 14.66.9 mmol/. HC1A was present on admission in 11 patients (31.5%). Its prevalance increased to 73% after recovery. AG/TCO2 ratios were unrelated to creatinine, level and PaCO2, but dependent on the ratio Na+/Cl (r=0.803;p<0.001, AG/TCO2=6.4 X (Na+/Cl)7.9). These data demonstrate that HC1A is not a respiratory or renal phenomenon and suggest differences in th Continue reading >>

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  1. picklechip5

    Costco has Kirkland-brand protein bars that are pretty much identical to Quest bars but a lot cheaper! They come in cookie dough and brownie flavor.

  2. Antranik

    Holy shit, this is a massive tip, thanks so much!!! Any idea what they're called?

  3. Iamam0nst3r

    https://www.reddit.com/r/keto/comments/4jeixc/costco_has_a_quest_bar_alternative_and_theyre/

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

Metabolic Acidosis? - Usmle Forum

A 42-year-old male is brought to ER immediately after a seizure episode. Family gives a history suggestive of grand mal seizures. Jim was on phenytoin for the past 10 years for his seizure disorder until he stopped it, six months ago. He had no seizures for the past nine years. On examination, patient is confused and lethargic. His vitals are, BP: 136/88 mm Hg, RR: 18/min, PR: 96/min. Which of the following is the most appropriate treatment for his metabolic D. Observe and repeat the labs after 2 hours. this pt. had and epileptic sz ...post seizure increased anion gap m.acidosis suggestive of lactic acidosis.. this caused by accelerated production of lactic acid in muscle and reduced hepatic lactate uptake however this post ictal lactic acidosis is transeint and resloves without treatment within 60 to 90 min so best intervention is to observe with 60 to 90 min. and repeat ABG after 2 hr. to see if acidosis resolved This patient has an acidic pH with a decrease in his bicarbonate concentration suggestive of metabolic acidosis. His AG is 140-(102+12) = 26. The patient had an epileptic seizure due to non-compliance with the medication. A post-seizure increased anion gap metabolic aci Continue reading >>

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  1. wild_wild_wes

    Keto strip test results

    I started Keto on Monday. Today I bought the Keto test strip kit a WalMart and just tried one. The color result put me somewhere in the SMALL (15) to MODERATE (40) range, but much closer to MODERATE.
    Is that okay?

  2. lbendall

    throw them away

  3. PullAndBear

    Originally Posted by lbendall
    throw them away

    um..why?

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