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What Is Hypochloremic Metabolic Acidosis?

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

Hypochloremia As A Consequence Of Anion Gap Metabolic Acidosis.

1. J Lab Clin Med. 1984 Jul;104(1):15-23. Hypochloremia as a consequence of anion gap metabolic acidosis. Anion gap acidosis is generally regarded as featuring a rather precise balancebetween the decrement in plasma HCO-3 and the increment in anion gap plasma Cl-remaining normal. In theory, therefore, the finding of hypochloremia inconjunction with an anion gap acidosis should evidence a coexisting metabolicalkalosis. In the clinical setting, however, hypochloremia is occasionally found in patients with anion gap acidosis but without exposure to a recognizedalkalosis-inducing process. To examine the possibility that an element ofhypochloremia might, under certain circumstances, be an integral part of theunderlying acidosis, we studied three forms of anion gap acidosis inunanesthetized, nephrectomized rats. In protocol I, 7 mEq/kg H+ as H2SO4 wasinfused over 1 hour. In protocol II, 24 mEq/kg H+ as D,L-lactic acid was infused over 3 hours. In protocol III, rats were maintained in the anephric state forapproximately 28 hours to permit uremic acidosis to develop. In each protocol,plasma C1- fell significantly (-8.0, -12.0, and -7.0 mEq/L in protocols I, II,and III, respectively) and c Continue reading >>

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  1. Margot LaNoue

    A few methods:
    - pee on a stick. There's a generic brand (I use Walgreen's) and the official brand. In general, they're called "ketone test strips" and they will change colors depending on the amount of ketone bodies in your urine. There is no "perfect level" of ketone bodies; you are either in ketosis or you are not. You will find these test strips in the same isle as the diabetic test stuff.
    - smell your breath. It will smell *awful* because a side product of ketosis is acetone in the urine and breath. While urine might always smell bad to you, your breath will smell truly, noticeably foul.
    - no bloating. Ketones do not bind with water the way glucose/glycogen does. You will not retain water when in ketosis. Nice!

  2. Cherie Nixon

    Warning: this might gross you out, but there's a simple answer to this question.
    OK, you want to know how you can tell? If you're in ketosis, you will often find oily residue floating in the toilet (assuming adequate lighting to see it). That's because while in ketosis, you excrete excess fat calories.

  3. Gary Wayne Nettoc

    The taste that people have mentioned is from the acetone in your breath, produced when you are in ketosis. There's a cool gadget that can measure that and let you know if you are in ketosis. KETONIX by Moose AB, Org.nr 556443-3794 It doesn't require strips or any replacement parts so in the long run it is the cheapest alternative.

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What is HYPOKALEMIC PERIODIC PARALYSIS? What does HYPOKALEMIC PERIOD PARALYSIS mean? HYPOKALEMIC PERIOD PARALYSIS meaning - HYPOKALEMIC PERIOD PARALYSIS definition - HYPOKALEMIC PERIOD PARALYSIS explanation. Source: Wikipedia.org article, adapted under https://creativecommons.org/licenses/... license. Hypokalemic periodic paralysis (hypoKPP) is a rare, autosomal dominant channelopathy characterized by muscle weakness or paralysis with a matching fall in potassium levels in the blood (primarily due to defect in a voltage-gated calcium channel). In individuals with this mutation, attacks often begin in adolescence and most commonly occur on awakening or after sleep or rest following strenuous exercise (attacks during exercise are rare), high carbohydrate meals, meals with high sodium content, sudden changes in temperature, and even excitement, noise, flashing lights and induced by cold temperatures. Weakness may be mild and limited to certain muscle groups, or more severe full-body paralysis. Attacks may last for a few hours or persist for several days. Recovery is usually sudden when it occurs, due to release of potassium from swollen muscles as they recover. Some patients may fall into an abortive attack or develop chronic muscle weakness later in life. To differentiate it from GuillainBarr syndrome, deep tendon reflexes are normal and 7th cranial nerve is spared. During an attack reflexes may be decreased or absent. Some people only develop symptoms of periodic paralysis due to hyperthyroidism (overactive thyroid). This entity is distinguished with thyroid function tests, and the diagnosis is instead called thyrotoxic periodic paralysis. Diagnosis can be achieved through a specialized form of electromyographic (EMG) testing called the long exercise test. This test measures the amplitude of a nerve response (called the Compound Muscle Action Potential or CMAP) for 40 to 50 minutes following a few minutes of exercise. In affected patients, there is a progressive fall in the amplitude of the potential. Besides the patient history or a report of serum potassium low normal or low during an attack, the long exercise test is the current standard for medical testing. Genetic diagnosis is often unreliable as only a few of the more common gene locations are tested, but even with more extensive testing 2037% of people with a clinical diagnosis of hypokalemic periodic paralysis have no known mutation in the two known genes. Standard EMG testing cannot diagnose a patient unless they are in a full blown attack at the time of testing. Provoking an attack with exercise and diet then trying oral potassium can be diagnostic, but also dangerous as this form of PP has an alternate form known as hyperkalemic periodic paralysis. The symptoms are almost the same, but the treatment is different. The old glucose insulin challenge is dangerous and risky to the point of being life-threatening and should never be done when other options are so readily available. People with hypokalemic periodic paralysis are often misdiagnosed as having a conversion disorder or hysterical paralysis since the weakness is muscle-based and doesn't correspond to nerve or spinal root distributions. The tendency of people with hypokalemic periodic paralysis to get paralyzed when epinephrine is released in "fight or flight" situations further adds to the temptation to misdiagnose the disorder as psychiatric.

Hypochloremic Hypokalemic Metabolic Alkalosis Archives - Roshreview.com

Published: September 27, 2017 | Author: Nachi Gupta, M.D., Ph.D., and Jeff Nusbaum, M.D. | Category: Blog , Podcasts | Tagged: a lines , aggressive cooling , agitation , anion gap metabolic acidosis , apnea , b lines , benzodiazepine , bilious projectile vomiting , bradycardia , confusion , deer mice , deferoxamine , dehydration , dermacentor , double decimal sign , doxycycline , ecmo , ecstasy , fever , fundal height , gestational sac , hantavirus , hemoperitoneum , hemorrhagic fever , hydration , hypertension , hypochloremic hypokalemic metabolic alkalosis , infectious diseases , iron overdose , Lung sliding , mdma , Mississippi river , neurology , obstetrics , operating room , pediatrics , photophobia , Pneumonia , Pneumothorax , pregnany , pubic symphysis , pulmonary edema , pulmonology , pyloric stenosis , resuscitation , rocky mountain spotted fever , serotonin syndrome , severe headache , shock , tachycardia , toxicology , Ultrasound , umbilicus , upper gi series , vagus nerve , xiphoid process , yolk sac | Read more Somewhere, something incredible is waiting to be known. -Sharon Begley Welcome back to Roshcast Episode 32! We are returning to our regular format letting the Continue reading >>

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  1. red_reader

    Neonatal ketosis -

    Neonatal ketosis -
    Suckling Ketogenesis (Williams, 1997)
    After normal blood glucose decline in first 3 hours, brisk ketogenic response in breastfed infants
    Ketone bodies provide alternative energy source for neonatal brain
    Breastfed babies tolerate lower blood glucose levels because their ketone body levels are elevated
    LGA infants of non-diabetic mothers will mount a sufficient ketogenic response to low blood sugar levels Link to PDF I realize this is not an actual study. I am looking for those specific references.
    AND
    Quote:
    Babies are in deep ketosis at birth and continue to be so until they are weaned off breast milk. I haven't looked to see how fast that decline out of ketosis happens after babies are weened off breast milk.
    Link to a list of scientific studies
    This leads me to believe that being in ketosis is actually the natural state, and out of ketosis is a result of excessive carbs ... ( crap your body doesn't need )

  2. bollockitis

    This leads me to believe that being in ketosis is actually the natural state, and out of ketosis is a result of excessive carbs ... ( crap your body doesn't need )
    The research is interesting, but I don't think it warrants that conclusion. Using that logic, you could say that because babies drink only breast milk, drinking breast milk is the natural state and eating anything else is unnatural.

  3. red_reader

    My conclusion is slightly different. Since breast milk is so high in fat ( causing the ketosis ) I feel that our natural diet should consist of high fat. Of note is that as soon as babies are taken off of breast milk and placed on ( man made ) formula, they fall out of ketosis.

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Hypochloremia - Symptoms, Causes And Treatment

Hypochloremia is an imbalance in electrolyte, where there is abnormal chlorine ion depletion in the blood. Normal value ranges from 97-107 mEq/L. However, in hypochloremia, the chloride levels become less than 98mEq/L. It is often associated with hypokalemia, hyponatremia and metabolic acidosis. Chloride is the major anion seen in both, the blood and the extracellular fluid. According to The Vitamins and Nutrition Center, chloride, potassium and calcium are among the most important serum electrolytes. Anion is nothing, but the negatively charged portion of some substances like sodium chloride (NaCl) or table salt, on getting dissolved in liquid. Maximum of chloride ions we get by the food we eat. The normal values increase as we consume more of canned foods rich in salt. Helps in keeping the acid-base balance in the body. Sea water and human fluids has the same concentration of chloride ions. Chloride ion balance is regulated and maintained by the body. Any significant decrease or increase may have harmful or fatal consequences. During digestion, the intestines absorb the chloride. Excess chloride after the digestion process, gets excreted in the urine. Kidneys control the chlorid Continue reading >>

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  1. clueless ✧

    Hi--I'm sorry, I'm sure this has been asked somewhere before, but I couldn't find anything (albiet, I didn't look very hard)
    I started marathon training a little while ago, but I was still having a high carb intake--now though, I've started lowering my carbs in order to get into keto... I've put a pause on the marathon training, but I'd still like to do long distance running. Are there any other runners who are doing low carb? I'm a bit of a newbie when it comes to this, I'm just looking for some advice--
    I'm having a hard time with getting up the energy to exercise for long amounts of time like I used to... will this go away the longer I'm doing a keto diet? How many carbs do you stick to if you run or exercise a lot? Does it kick you out of keto at all?

  2. Dreams-are-free

    Hey there!
    I'm a long distance runner too! I'm no stranger to ketosis via fasting,but this is only my third day on the keto diet.
    When fasting I hardly exercise, just yoga, which is why I hate it. I always crave running or hiking.
    Ive found by day 3 my exercise tolerance is a little low (out of breath walking up slight gradients) however, since we are fueling our bodies then exercise in general will not be bad.
    In terms of running, our bodies use up the carbs in our blood stream and liver before moving to fat, so if running for 30min then carbs will get used. The longer you go, then your body naturally shifts to using fat as fuel anywau.. so, I.reckon low carbs just means we use fats for fuel earlier and that it shouldnt be a problem.
    Dont know if that helps? Ive been wondering too, but many things I've read suggest that cardio training is great for fatloss in keto, vs muscle training. So.. it must be ok?

  3. plant matter

    How long have you been on the keto diet? It's possible that you're currently going through induction or you're not too deep into ketosis yet. During the induction phase you shouldn't push yourself very hard in exercise as your body is in the middle of trying to switch "operating systems" if you will, from utilizing glycolysis as a primary energy source to utilizing ketogenesis as a primary energy source. This is a stressful event for your body, particularly if you've never done keto before. Wait until you pass through induction to try your normal routines -- and from reading personal anecdotes online, once you're over the initial hump, exercise becomes easier/more gratifying, you have more energy while doing it, and your results will be better.
    tl;dr
    You probably have keto flu. Take it easy until it passes.

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