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Starvation Acidosis

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

Starvation Ketoacidosis: A Cause Of Severe Anion Gap Metabolic Acidosis In Pregnancy

Starvation Ketoacidosis: A Cause of Severe Anion Gap Metabolic Acidosis in Pregnancy Division of Pulmonary and Critical Care Medicine, Bronx Lebanon Hospital Center and Albert Einstein College of Medicine, Bronx, NY 10457, USA Received 21 February 2014; Revised 6 May 2014; Accepted 6 May 2014; Published 20 May 2014 Copyright 2014 Nupur Sinha et al. This is an open access article distributed under the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Pregnancy is a diabetogenic state characterized by relative insulin resistance, enhanced lipolysis, elevated free fatty acids and increased ketogenesis. In this setting, short period of starvation can precipitate ketoacidosis. This sequence of events is recognized as accelerated starvation. Metabolic acidosis during pregnancy may have adverse impact on fetal neural development including impaired intelligence and fetal demise. Short periods of starvation during pregnancy may present as severe anion gap metabolic acidosis (AGMA). We present a 41-year-old female in her 32nd week of pregnancy, admitted with severe AGMA with pH 7 Continue reading >>

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Popular Questions

  1. Audrey's Momma

    I'm trying to do the best, but I feel like a bit of a bad cat Momma.
    Audrey was diagnosed some time ago. She is still urinating lakes and rivers, thirsty and hungry and refuses to use the litter box. Her numbers are high. I had stopped testing last year as I felt so bad for poking her. She is a bit of a tiger when it comes to testing. I know it's the best for her, but a person cannot help but feeling bad for putting them through this even though we know it's best for them. She was put on treatment with antibiotics for a UTI a few weeks ago and she is still voiding everywhere.
    I have resumed testing within the last few days and she puts up with it.
    My veterinarian was receptive in my doing a 24 hour home BG curve. For that, I'm thankful. I'm working on this as best as I can. I use a ReliOn meter and her numbers are always 400-500.
    We are going away soon for 2 weeks and I am boarding her. I am worried for them in putting up with her urinating and pooping outside the box.
    She is fed 1/2 can of Friskies Pate 3 times a day ( or Fancy Feast Pate) and she is on 2 Units of Levemir morning and evening. I give her 4-6 tiny chicken pieces after each time I shoot as an incentive.
    Sometimes I feel like such a failure, but she seems to be happy one, despite my not doing the testing I should be doing. I'm trying! And venting...

  2. rhiannon and shadow (GA)

    first of all....
    it can be frustrating....
    and some kitties are slower to regulate than others....
    but ...
    especially when you return.....
    come post over in the lantus/levemir forum because with daily posting and advising.....
    we can help you get her to better numbers....
    the excessive thirst and peeing will continue until you get her in numbers under 200 all the time.....
    yes ...
    you need to test... but those treats should teach her to cooperate with practice....
    also.... are you testing for ketones..... ( that means catching urine samples and dipping a ketostix in it to check ketone levels)
    will your vet do any testing while boarded?
    There are a few out there who shoot a dose in the evening but then no one is in the office until the next morning.
    I would ask questions about that.
    then when you return....
    the dose will likely need to be incrementally ( 0.25 u at a time) be increased.
    That's why I hope you will come post in the other forum.
    Scritches to Audrey...

  3. Squalliesmom

    rhiannon and shadow (GA) said: ↑
    first of all....
    it can be frustrating....
    and some kitties are slower to regulate than others....
    but ...
    especially when you return.....
    come post over in the lantus/levemir forum because with daily posting and advising.....
    we can help you get her to better numbers....
    the excessive thirst and peeing will continue until you get her in numbers under 200 all the time.....
    yes ...
    you need to test... but those treats should teach her to cooperate with practice....
    also.... are you testing for ketones..... ( that means catching urine samples and dipping a ketostix in it to check ketone levels)
    will your vet do any testing while boarded?
    There are a few out there who shoot a dose in the evening but then no one is in the office until the next morning.
    I would ask questions about that.
    then when you return....
    the dose will likely need to be incrementally ( 0.25 u at a time) be increased.
    That's why I hope you will come post in the other forum.
    Scritches to Audrey...
    Click to expand... I was going to reply but Rhiannon has pretty much said everything I would have, lol. And she's right, if you post on the Lantus/Levemir forum you'll get responses and help from people who are most familiar with those insulins.
    Please don't feel like you're a failure, you are NOT. You're doing everything you can to help Audrey.

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In this video I discuss what is stress, why is stress bad, and what causes stress. I also cover how stress is bad, how to deal with stress, and stress management. Transcript What is stress? Whats up dudes, and whats up ladies, Bryan here and in this video we are going to look at stress. What is it, what causes it, and what can we do about it? So, Lets roll. Stress hormones Stress is your body's way of reacting to any kind of demand or threat. When the body feels stress, your hypothalamus, a tiny region in your brain, signals your adrenal glands, located atop your kidneys, to release a surge of hormones, which include adrenaline and cortisol, into the bloodstream. As these hormones are released, the liver is triggered to produce more blood sugar, which gives you an energy kick, breathing becomes more rapid, and heart beat and blood pressure rise. If the stress is caused by physical danger, these chemicals can be beneficial, as they give you more energy and strength, and also speed up your reaction time and enhance your focus. But, if the stress is caused by something emotional, it can be harmful, because there is no outlet for this extra energy and strength. Once the source of the s

Severe Acidosis Caused By Starvation And Stress - Sciencedirect

Volume 42, Issue 5 , November 2003, Pages e22.1-e22.4 Get rights and content A 1-year-old boy had severe anoxic brain injury owing to a cardiorespiratory arrest. He had an initial metabolic acidosis, but this largely resolved by hospital day 2. He then had a persistent, profound metabolic acidosis. Evaluation on hospital day 6 found that the patient had ketonemia, ketonuria, and a normal serum glucose level; he had received no intravenous dextrose during his hospitalization. The dextrose-free fluids were given initially to protect his brain from the deleterious effects of hyperglycemia after brain injury. Continuation beyond 24 hours was inadvertent. The initiation of dextrose-containing intravenous fluids produced a rapid resolution of his metabolic acidosis. Starvation usually produces a mild metabolic acidosis, but when combined with physiologic stress, starvation may cause a severe metabolic acidosis. Among the few reports of severe starvation ketoacidosis, our case is unique because the patient was monitored closely in an intensive care unit, allowing us to describe the time course of the acidosis in detail. Continue reading >>

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Popular Questions

  1. ThinInHere

    Today is day 3 on induction for me, and while I feel great having already lost 3lbs (yay!), I've noticed that shortly after I eat I get nauseous. Is this normal, and if so, is it just in the beginning or will it last?

  2. ElleH

    I feel nauseous when I'm hungry in ketosis, but not after I eat. Hopefully others will have input for you, but I know that while the body is adjusting to ketosis, a wide range of effects can be felt in different people.

  3. ThinInHere

    Elle,
    Thanks for your quick reply. I was actually thinking it may be due to ketosis and the fact that I'm "detoxing" from carbs. This is a huge adjustment for me as I was eating primarily all carbs prior to beginning Atkins.

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Subscribe for videos on becoming superhuman: https://goo.gl/TSDCuv Lowering your caloric intake and doing intermittent fasting has a ton of health benefits on both your body and your mind. Herman Hesse said in his novel, Siddhartha: Everyone can perform magic, everyone can reach his goals, if he is able to think, if he is able to wait, if he is able to fast. Numerous studies have shown that caloric restriction increases the lifespan and youthfulness of almost all species, starting with fruit flies and ending with rhesus monkeys. In humans, there is no definite anti-aging proof but fastings been shown to improve biomarkers, reduce inflammation, promote stem cell growth, boost the immune system and make you burn a ton of fat. However, the key to successfully gaining these health benefits comes from avoiding malnutrition and starvation. Theres a hugedifference between fasting, starvationand caloric restriction, but it doesn't mean you can't be starving while intermittent fasting or consuming fewer calories. This video tells you how to avoid starvation mode while fasting and gain the longevity benefits More In-Depth video on autophagy: https://www.youtube.com/watch?v=_2kW_... Read the

Severe Acidosis Caused By Starvation And Stress.

Severe acidosis caused by starvation and stress. Department of Pediatrics, Children's Hospital of Wisconsin, Milwauke, WI, USA. A 1-year-old boy had severe anoxic brain injury owing to a cardiorespiratory arrest. He had an initial metabolic acidosis, but this largely resolved by hospital day 2. He then had a persistent, profound metabolic acidosis. Evaluation on hospital day 6 found that the patient had ketonemia, ketonuria, and a normal serum glucose level; he had received no intravenous dextrose during his hospitalization. The dextrose-free fluids were given initially to protect his brain from the deleterious effects of hyperglycemia after brain injury. Continuation beyond 24 hours was inadvertent. The initiation of dextrose-containing intravenous fluids produced a rapid resolution of his metabolic acidosis. Starvation usually produces a mild metabolic acidosis, but when combined with physiologic stress, starvation may cause a severe metabolic acidosis. Among the few reports of severe starvation ketoacidosis, our case is unique because the patient was monitored closely in an intensive care unit, allowing us to describe the time course of the acidosis in detail. Continue reading >>

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Popular Questions

  1. formyhealth

    I get mouth sores when going into ketosis (and I guess being in ketosis, too). I have noticed that this happens and its been pretty consistent over the last decade. Today I got a new one and I think its because I didn't drink my normal amount of water (a gallon) yesterday. Does this happen to anyone else? Do you agree about the water?

  2. SweetSugaree

    Hi,
    I get mouth sores as well when I do not drink tons of water like I should. I will wake up in the morning with a sore due to dry mouth. What I have learned to do is keep water next to my bed, also, I make sure before i go to bed I drink a cup of water or so. One thing I also do is right before bed I swish with Biotene. It really does help a lot. Hope you can find some things that work for you.

  3. E.W.

    Are you talking about canker sores, those small real painful sores? If you are I
    found that if I went to bed with a milk of magnesia tablet on it by the time i got up
    in the morning it was almost gone. Sure it hurts for a moment when you first put
    it on the sore but this only last a few seconds. Then just put another one or 2 on the
    sore during the day and it's gone.

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