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Why Severe Acidosis Is A Problem?

Note The Normal Ph Of Blood And Discuss Why Severe Acidosis Is A Problem?

Note The Normal Ph Of Blood And Discuss Why Severe Acidosis Is A Problem?

Note the normal pH of blood and discuss why severe acidosis is a problem? Are you sure you want to delete this answer? Best Answer: pH of blood is slightly alkaline 7.35-7.45 Acidosis denatures enzymes which are vital to cell function. Acidosis disturbs cellular ionic transport across cell and electrical charge on membranes. eg. in glomerular membranes or neuronal membranes. It shifts the Hemoglobin oxygen dissociation curve to the right making oxygen loading difficult in the lungs. Histones are basic proteins binding DNA which in acidosis may cause DNA becoming unstable. Source(s): Reverse Any Diabetes Easily - if the blood becomes to acidic what happens is it denatures things I think this question violates the Community Guidelines Chat or rant, adult content, spam, insulting other members, show more I think this question violates the Terms of Service Harm to minors, violence or threats, harassment or privacy invasion, impersonation or misrepresentation, fraud or phishing, show more If you believe your intellectual property has been infringed and would like to file a complaint, please see our Copyright/IP Policy I think this answer violates the Community Guidelines Chat or rant, adult content, spam, insulting other members, show more I think this answer violates the Terms of Service Harm to minors, violence or threats, harassment or privacy invasion, impersonation or misrepresentation, fraud or phishing, show more If you believe your intellectual property has been infringed and would like to file a complaint, please see our Copyright/IP Policy I think this comment violates the Community Guidelines Chat or rant, adult content, spam, insulting other members, show more I think this comment violates the Terms of Service Harm to minors, violence or threats, harassment or p Continue reading >>

Patient With A Severe Degree Of Metabolic Acidosis: A Deductive Analysis | Qjm: An International Journal Of Medicine | Oxford Academic

Patient With A Severe Degree Of Metabolic Acidosis: A Deductive Analysis | Qjm: An International Journal Of Medicine | Oxford Academic

This teaching exercise demonstrates how principles of physiology might help in identifying the cause of a particularly severe case of metabolic acidosis and making appropriate decisions about therapy. The patient's plasma pH was 7.00 and their plasma bicarbonate concentration was 2 mmol/l. Because the time course of the patient's illness was believed to be <24 h, this suggested that a large quantity of acid had been added to the body in this short time period, but the medical team managing the case could not identify any acid that could have been produced rapidly by endogenous processes, or was ingested by the patient. Moreover, there was a question about how such a very low arterial PCO 2 (8 mmHg) could be sustained. Even once the diagnosis was made, there were issues to resolve concerning therapy. These included questions about how much sodium bicarbonate to administer, and what dangers might arise during this therapy. The missing links in this interesting story emerge during a discussion between the medical team and their imaginary mentor, Professor McCance. In this clinical teaching exercise, the central figure is the imaginary consultant Professor McCance, who practiced medicine 70 years ago. His overall objective is to demonstrate how applying the principles of integrative physiology at the bedside, together with a quantitative analysis, can reveal the pathophysiology of disease, lead to more accurate clinical diagnoses, and help determine optimal therapy. There was a vigorous discussion among the medical team at morning rounds concerning the diagnosis and treatment for a patient who had been admitted the previous night. He presented with a very short illness and displayed a severe degree of metabolic acidosis, with a pH of 7.00 and plasma bicarbonate concentrati Continue reading >>

Metabolic Acidosis In Emergency Medicinetreatment & Management

Metabolic Acidosis In Emergency Medicinetreatment & Management

Metabolic Acidosis in Emergency MedicineTreatment & Management Author: Antonia Quinn, DO; Chief Editor: Romesh Khardori, MD, PhD, FACP more... The initial therapeutic goal for patients with severe acidemia is to raise the systemic pH above 7.1-7.2, a level at which dysrhythmias become less likely and cardiac contractility and responsiveness to catecholamines will be restored. Metabolic acidosis can be reversed by treating the underlying condition or by replacing the bicarbonate. The decision to give bicarbonate should be based upon the pathophysiology of the specific acidosis, the clinical state of the patient, and the degree of acidosis. [ 10 ] Treating the underlying conditions in high AG states usually is sufficient in reversing the acidosis. Treatment with bicarbonate is unnecessary, except in extreme cases of acidosis when the pH is less than 7.1-7.2. For all cases of diabetic ketoacidosis, the role of bicarbonate is controversial, regardless of the pH or bicarbonate level. In hyperchloremic acidosis, the central problem is with the reabsorption or regeneration of bicarbonate. In these conditions, therapy with bicarbonate makes physiologic sense and is prudent in patients with severe acidosis. Caution with bicarbonate therapy is indicated because of its potential complications, including the following: Tissue hypoxia via leftward shift of hemoglobin-oxygen dissociation curve Alkali stimulation of organic acidosis (lactate) Metabolic acidosis secondary to ingestions (eg, salicylate, methanol, ethylene glycol) often requires dialysis therapy, and a nephrologist should be consulted early in the case management. Toxicologic consultation should also be considered in such cases. Dialysis is the preferred treatment for patients with significant metabolic acidosis in the Continue reading >>

Critical Thinking And Clinical Application Questions, Chapter 2

Critical Thinking And Clinical Application Questions, Chapter 2

Critical Thinking and Clinical Application Questions, Chapter 2 In a freshwater lake, there are comparatively few electrolytes (salts) to carry a current away from a swimmer's body. Hence, the body would be a better conductor of the current and the chance of a severe electrical shock if lightning hit the water is real. As Ben jumped on his bike and headed for the freshwater lake, his mother called after him, "Don't swim if we have an electrical stormit looks threatening." This was a valid request. Why? a. -Some antibiotics compete with the substrate at the active site of the enzyme. This would tend to reduce the effectiveness of the reaction. b. Because the bacteria would be unable to catalyze the essential chemical reactions normally brought about by the "blocked" enzymes, the anticipated effect would be the inhibition of its metabolic activities. This would allow white blood cells to remove them from the system. However, some human cells would also be affected and this could cause them to cease their functions, hopefully only temporarily. Some antibiotics act by binding to certain essential enzymes in the target bacteria. (a) How might these antibiotics influence the chemical reactions controlled by the enzymes? (b) What is the anticipated effect on the bacteria? On the person taking the antibiotic prescription? a. -pH is defined as the measurement of the hydrogen ion concentration in a solution. The normal blood pH is 7.4. b. Severe acidosis is critical because it can adversely affect cell membranes, the function of the kidneys, muscle contraction, and neural activity. Mrs. Roberts, in a diabetic coma, has just been admitted to Noble Hospital. Her blood pH indicates that she is in severe acidosis, and measures are quickly instituted to bring her blood pH back within Continue reading >>

For Patients And Visitors

For Patients And Visitors

Definition Metabolic acidosis is a condition in which there is too much acid in the body fluids. Alternative Names Acidosis - metabolic Causes Metabolic acidosis occurs when the body produces too much acid. It can also occur when the kidneys are not removing enough acid from the body. There are several types of metabolic acidosis. Diabetic acidosis develops when acidic substances, known as ketone bodies, build up in the body. This most often occurs with uncontrolled type 1 diabetes. It is also called diabetic ketoacidosis and DKA. Hyperchloremic acidosis results from excessive loss of sodium bicarbonate from the body. This can occur with severe diarrhea. Lactic acidosis results from a buildup of lactic acid. It can be caused by: Alcohol Cancer Exercising intensely Liver failure Medicines, such as salicylates Prolonged lack of oxygen from shock, heart failure, or severe anemia Seizures Other causes of metabolic acidosis include: Kidney disease (distal renal tubular acidosis and proximal renal tubular acidosis) Poisoning by aspirin, ethylene glycol (found in antifreeze), or methanol Severe dehydration Symptoms Most symptoms are caused by the underlying disease or condition that is causing the metabolic acidosis. Metabolic acidosis itself most often causes rapid breathing. Acting confused or very tired may also occur. Severe metabolic acidosis can lead to shock or death. In some situations, metabolic acidosis can be a mild, ongoing (chronic) condition. Exams and Tests These tests can help diagnose acidosis. They can also determine whether the cause is a breathing problem or a metabolic problem. Tests may include: Arterial blood gas Basic metabolic panel, (a group of blood tests that measure your sodium and potassium levels, kidney function, and other chemicals and function Continue reading >>

Acidosis

Acidosis

The kidneys and lungs maintain the balance (proper pH level) of chemicals called acids and bases in the body. Acidosis occurs when acid builds up or when bicarbonate (a base) is lost. Acidosis is classified as either respiratory or metabolic acidosis. Respiratory acidosis develops when there is too much carbon dioxide (an acid) in the body. This type of acidosis is usually caused when the body is unable to remove enough carbon dioxide through breathing. Other names for respiratory acidosis are hypercapnic acidosis and carbon dioxide acidosis. Causes of respiratory acidosis include: Chest deformities, such as kyphosis Chest injuries Chest muscle weakness Chronic lung disease Overuse of sedative drugs Metabolic acidosis develops when too much acid is produced in the body. It can also occur when the kidneys cannot remove enough acid from the body. There are several types of metabolic acidosis: Diabetic acidosis (also called diabetic ketoacidosis and DKA) develops when substances called ketone bodies (which are acidic) build up during uncontrolled diabetes. Hyperchloremic acidosis is caused by the loss of too much sodium bicarbonate from the body, which can happen with severe diarrhea. Poisoning by aspirin, ethylene glycol (found in antifreeze), or methanol Lactic acidosis is a buildup of lactic acid. Lactic acid is mainly produced in muscle cells and red blood cells. It forms when the body breaks down carbohydrates to use for energy when oxygen levels are low. This can be caused by: Cancer Drinking too much alcohol Exercising vigorously for a very long time Liver failure Low blood sugar (hypoglycemia) Medications, such as salicylates MELAS (a very rare genetic mitochondrial disorder that affects energy production) Prolonged lack of oxygen from shock, heart failure, or seve Continue reading >>

What Is Metabolic Acidosis?

What Is Metabolic Acidosis?

Metabolic acidosis happens when the chemical balance of acids and bases in your blood gets thrown off. Your body: Is making too much acid Isn't getting rid of enough acid Doesn't have enough base to offset a normal amount of acid When any of these happen, chemical reactions and processes in your body don't work right. Although severe episodes can be life-threatening, sometimes metabolic acidosis is a mild condition. You can treat it, but how depends on what's causing it. Causes of Metabolic Acidosis Different things can set up an acid-base imbalance in your blood. Ketoacidosis. When you have diabetes and don't get enough insulin and get dehydrated, your body burns fat instead of carbs as fuel, and that makes ketones. Lots of ketones in your blood turn it acidic. People who drink a lot of alcohol for a long time and don't eat enough also build up ketones. It can happen when you aren't eating at all, too. Lactic acidosis. The cells in your body make lactic acid when they don't have a lot of oxygen to use. This acid can build up, too. It might happen when you're exercising intensely. Big drops in blood pressure, heart failure, cardiac arrest, and an overwhelming infection can also cause it. Renal tubular acidosis. Healthy kidneys take acids out of your blood and get rid of them in your pee. Kidney diseases as well as some immune system and genetic disorders can damage kidneys so they leave too much acid in your blood. Hyperchloremic acidosis. Severe diarrhea, laxative abuse, and kidney problems can cause lower levels of bicarbonate, the base that helps neutralize acids in blood. Respiratory acidosis also results in blood that's too acidic. But it starts in a different way, when your body has too much carbon dioxide because of a problem with your lungs. Continue reading >>

Acidosis

Acidosis

For acidosis referring to acidity of the urine, see renal tubular acidosis. "Acidemia" redirects here. It is not to be confused with Academia. Acidosis is a process causing increased acidity in the blood and other body tissues (i.e., an increased hydrogen ion concentration). If not further qualified, it usually refers to acidity of the blood plasma. The term acidemia describes the state of low blood pH, while acidosis is used to describe the processes leading to these states. Nevertheless, the terms are sometimes used interchangeably. The distinction may be relevant where a patient has factors causing both acidosis and alkalosis, wherein the relative severity of both determines whether the result is a high, low, or normal pH. Acidosis is said to occur when arterial pH falls below 7.35 (except in the fetus – see below), while its counterpart (alkalosis) occurs at a pH over 7.45. Arterial blood gas analysis and other tests are required to separate the main causes. The rate of cellular metabolic activity affects and, at the same time, is affected by the pH of the body fluids. In mammals, the normal pH of arterial blood lies between 7.35 and 7.50 depending on the species (e.g., healthy human-arterial blood pH varies between 7.35 and 7.45). Blood pH values compatible with life in mammals are limited to a pH range between 6.8 and 7.8. Changes in the pH of arterial blood (and therefore the extracellular fluid) outside this range result in irreversible cell damage.[1] Signs and symptoms[edit] General symptoms of acidosis.[2] These usually accompany symptoms of another primary defect (respiratory or metabolic). Nervous system involvement may be seen with acidosis and occurs more often with respiratory acidosis than with metabolic acidosis. Signs and symptoms that may be seen i Continue reading >>

Merck And The Merck Manuals

Merck And The Merck Manuals

Acidosis is caused by an overproduction of acid in the blood or an excessive 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 depressed breathing (respiratory acidosis). If an increase in acid overwhelms the body's acid-base control systems, the blood will become acidic. As blood pH drops (becomes more acidic), the parts of the brain that regulate breathing are stimulated to produce faster and deeper breathing (respiratory compensation). 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 produce too much acid, leading to severe acidosis and eventually heart problems and coma. The acidity or alkalinity of any solution, including blood, is indicated on the pH scale. Metabolic acidosis develops when the amount of acid in the body is increased through ingestion of a substance that is, or can be broken down (metabolized) to, an acid—such as wood alcohol (methanol), antifreeze (ethylene glycol), or large doses of aspirin (acetylsalicylic acid). Metabolic acidosis can also occur as a result of abnormal metabolism. The body produces excess acid in the advanced stages of shock and in poorly controlled type 1 diabetes mellitus (diabetic ketoacidosis). Even the production of normal amounts of acid may lead to acidosis when the kidneys are not functioning normally and are therefore not able to excrete sufficient amounts of acid in the urine. Major Causes of Metabolic Acidosis Diabetic ketoacidosis (buildup of ketoacids) Drugs and substances such as acetazolamide, alcohols, and aspirin Lactic acidosis (buildup of lactic acid Continue reading >>

41 Mrs Roberts Who Is In A Diabetic Coma Has Just Been Admitted To Noble

41 Mrs Roberts Who Is In A Diabetic Coma Has Just Been Admitted To Noble

andstopthegrowthonofthevirustolettheimmunesystemgetbetter.41.Mrs.Roberts,whoisinadiabeticcoma,hasjustbeenadmittedtoNobleHospital.HerbloodpHindicatedthatsheisinsevereacidosis(bloodpHisintheacidrange),andthemedicalstaffquicklyinstitutemeasurestobringherbloodpHbackwithinnormallimits.NotethenormalpHofbloodanddiscusswhysevereacidosisisaproblem.NormalpHforbloodis7.4Severeacidosisisaproblembecauseitcanaffectcellmembranes,functionofthekidneys,musclecontractionandneuralactivity42.Sarahisquiteproudofherslender,modellikefigureandboaststhatshedoesnthaveanounceofexcessbodyfat.Lauren,incontrast,ontheotherhand,isgrosslyoverweight.Shecomplainsoffeelinghotmostofthetimeandonahotdaysheismiserable.Sarahgenerallyfeelschilledexceptonveryhotdays.Explaintherelativesensitivitytoenvironmentaltemperaturesofthesetwowomenonthebasisoftheinformationyouhavebeengivenintheorganiccompoundssectionofthischapter.DuetothelackofbodyfatSarasbodyisunabletoproducethenormalamountofheatherbodyneedsbecauseshedoesnthaveanystoredenergyDuetoLaurenbeingoverweight,herbodyisoverheatingbecauseshehastoomuchbodyfatandherbodydoesntuseupalloftheenergyOrganiccompoundssuchascarbohydrates,lipidsandproteinscancausethebodytoreactdifferentdependingonthehowmuchorhowlittleofeachcompoundourbodyhasstoredInthiscaseSaraslackofcompoundsmakeshertofeelcoldonmostdaysandLaurensexcessamountofbodyfatmakesherfeelhotandcauseshertooverheat. This preview has intentionally blurred sections. Sign up to view the full version. Continue reading >>

Acidosis

Acidosis

When your body fluids contain too much acid, it’s known as acidosis. Acidosis occurs when your kidneys and lungs can’t keep your body’s pH in balance. Many of the body’s processes produce acid. Your lungs and kidneys can usually compensate for slight pH imbalances, but problems with these organs can lead to excess acid accumulating in your body. The acidity of your blood is measured by determining its pH. A lower pH means that your blood is more acidic, while a higher pH means that your blood is more basic. The pH of your blood should be around 7.4. According to the American Association for Clinical Chemistry (AACC), acidosis is characterized by a pH of 7.35 or lower. Alkalosis is characterized by a pH level of 7.45 or higher. While seemingly slight, these numerical differences can be serious. Acidosis can lead to numerous health issues, and it can even be life-threatening. There are two types of acidosis, each with various causes. The type of acidosis is categorized as either respiratory acidosis or metabolic acidosis, depending on the primary cause of your acidosis. Respiratory acidosis Respiratory acidosis occurs when too much CO2 builds up in the body. Normally, the lungs remove CO2 while you breathe. However, sometimes your body can’t get rid of enough CO2. This may happen due to: chronic airway conditions, like asthma injury to the chest obesity, which can make breathing difficult sedative misuse deformed chest structure Metabolic acidosis Metabolic acidosis starts in the kidneys instead of the lungs. It occurs when they can’t eliminate enough acid or when they get rid of too much base. There are three major forms of metabolic acidosis: Diabetic acidosis occurs in people with diabetes that’s poorly controlled. If your body lacks enough insulin, keton Continue reading >>

Physiological Effects Of Hyperchloraemia And Acidosis

Physiological Effects Of Hyperchloraemia And Acidosis

Physiological effects of hyperchloraemia and acidosis Chelsea and Westminster NHS Foundation Trust Chelsea and Westminster NHS Foundation Trust BJA: British Journal of Anaesthesia, Volume 101, Issue 2, 1 August 2008, Pages 141150, J. M. Handy, N. Soni; Physiological effects of hyperchloraemia and acidosis, BJA: British Journal of Anaesthesia, Volume 101, Issue 2, 1 August 2008, Pages 141150, The advent of balanced solutions for i.v. fluid resuscitation and replacement is imminent and will affect any specialty involved in fluid management. Part of the background to their introduction has focused on the non-physiological nature of normal saline solution and the developing science about the potential problems of hyperchloraemic acidosis. This review assesses the physiological significance of hyperchloraemic acidosis and of acidosis in general. It aims to differentiate the effects of the causes of acidosis from the physiological consequences of acidosis. It is intended to provide an assessment of the importance of hyperchloraemic acidosis and thereby the likely benefits of balanced solutions. Hyperchloraemic acidosis is increasingly recognized as a clinical entity, a new enemy within, that had gone otherwise unnoticed for decades. Although any associated morbidity may be subtle at present, there is a trend in current evidence to suggest that hyperchloraemic acidosis may have adverse consequences which may be circumvented by the use of balanced solutions. These consequences, both theoretical and clinical, may result from hyperchloraemia, acidosis, or both. There is some evidence of hyperchloraemia causing problems, but at present the clinical relevance is uncertain. The literature does appear to be unified in stating that acidosis results in adverse physiological effects bu Continue reading >>

What Is The Normal Ph Of Blood And Why Is Severe Acidosis A

What Is The Normal Ph Of Blood And Why Is Severe Acidosis A

What is the normal pH of blood and why is severe acidosis a problem Experience: Working as a Doctor who Cares since 2001. Normal blood pH is within the narrow range of 7.35 to 7.45 {slightly alkaline}. There are many systems which keep this thin balance. Increased acidosis can cause abnormal functioning of the body like - Confusion, Lethargy, Rapid breathing, Shortness of breath, Wheezing. Untreated acidosis can be serious and lead to effects on bones/ lungs / heart and brain. Experience: Working as a Doctor who Cares since 2001. Ken and 87 other Medical Specialists are ready to help you Experience: Working as a Doctor who Cares since 2001. A new question is answered every 9 seconds Ask an ExpertExperts are full of valuable knowledge and are ready to help with any question. Credentials confirmed by a Fortune 500 verification firm. Get a Professional AnswerVia email, text message, or notification as you wait on our site. Ask follow up questions if you need to. 100% Satisfaction GuaranteeRate the answer you receive. Ask-a-doc Web sites: If you've got a quick question, you can try to get an answer from sites that say they have various specialists on hand to give quick answers... Justanswer.com. JustAnswer.com...has seen a spike since October in legal questions from readers about layoffs, unemployment and severance. Traffic on JustAnswer rose 14 percent...and had nearly 400,000 page views in 30 days...inquiries related to stress, high blood pressure, drinking and heart pain jumped 33 percent. Tory Johnson, GMA Workplace Contributor, discusses work-from-home jobs, such as JustAnswer in which verified Experts answer peoples questions. I will tell you that...the things you have to go through to be an Expert are quite rigorous. I feel so much better today, and upon further inv Continue reading >>

Severe Metabolic Acidosis During Haemodialysis: A Rare But Life Threatening Complication

Severe Metabolic Acidosis During Haemodialysis: A Rare But Life Threatening Complication

Severe metabolic acidosis during haemodialysis: a rare but life threatening complication Nephrology Dialysis Transplantation, Volume 16, Issue 12, 1 December 2001, Pages 24162417, Costas Fourtounas, Ioannis Kopelias, George Dimitriadis, Aris Paraskevopoulos, Basil Agroyannis; Severe metabolic acidosis during haemodialysis: a rare but life threatening complication, Nephrology Dialysis Transplantation, Volume 16, Issue 12, 1 December 2001, Pages 24162417, Dialysis fluids are real drugs and as a consequence they need pharmacological preparation in order to meet the criteria of quality and standarization. Modern dialysis machines permit accurate proportioning of treated water and salts and also guarantee a continuous monitoring of the accuracy of the final composition and maintenance of the desired proportions. However, errors with dialysate concentrations are numerous and may go underdetected as causes of morbidity and mortality in patients undergoing haemodialysis (HD) [ 1 ]. Two cases of severe metabolic acidosis as complications of HD have been recorded in two dialysis units, which have been dialysing more than 50 patients daily during the last 5 years. Early recognition and proper treatment resulted in favourable outcome. A 54yearold male patient, on acetate HD for 5 years due to chronic glomerulonephritis, complained that something strange was going on, and asked the nursing staff to disconnect him from the machine. He was in the first hour of his HD session, during the first shift of the day, and was being dialysed with a Cobe Centry 2000 HD machine. A relevant comorbidity, which he had, was chronic obstructive pulmonary disease. When examined after his complaint, his blood pressure was 155/85 mmHg, pulse 90/min and he was tachypneic (30 breaths/min). Blood gas anal Continue reading >>

Disorders Of Acid-base Balance

Disorders Of Acid-base Balance

Module 10: Fluid, Electrolyte, and Acid-Base Balance By the end of this section, you will be able to: Identify the three blood variables considered when making a diagnosis of acidosis or alkalosis Identify the source of compensation for blood pH problems of a respiratory origin Identify the source of compensation for blood pH problems of a metabolic/renal origin Normal arterial blood pH is restricted to a very narrow range of 7.35 to 7.45. A person who has a blood pH below 7.35 is considered to be in acidosis (actually, physiological acidosis, because blood is not truly acidic until its pH drops below 7), and a continuous blood pH below 7.0 can be fatal. Acidosis has several symptoms, including headache and confusion, and the individual can become lethargic and easily fatigued. A person who has a blood pH above 7.45 is considered to be in alkalosis, and a pH above 7.8 is fatal. Some symptoms of alkalosis include cognitive impairment (which can progress to unconsciousness), tingling or numbness in the extremities, muscle twitching and spasm, and nausea and vomiting. Both acidosis and alkalosis can be caused by either metabolic or respiratory disorders. As discussed earlier in this chapter, the concentration of carbonic acid in the blood is dependent on the level of CO2 in the body and the amount of CO2 gas exhaled through the lungs. Thus, the respiratory contribution to acid-base balance is usually discussed in terms of CO2 (rather than of carbonic acid). Remember that a molecule of carbonic acid is lost for every molecule of CO2 exhaled, and a molecule of carbonic acid is formed for every molecule of CO2 retained. Figure 1. Symptoms of acidosis affect several organ systems. Both acidosis and alkalosis can be diagnosed using a blood test. Metabolic Acidosis: Primary Bic Continue reading >>

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