Lactic acidosis: Difference between revisions
| Line 22: | Line 22: | ||
==DDX Complete== | ==DDX Complete== | ||
#Any shock state | #Any shock state | ||
#Seizure | #[[Seizure]] | ||
#Dead gut | #Dead gut | ||
#Hepatic failure | #Hepatic failure | ||
| Line 29: | Line 29: | ||
#Use of b‐agonists | #Use of b‐agonists | ||
#Toxicologic Causes: | #Toxicologic Causes: | ||
##Cyanide | ##[[Cyanide]] | ||
##Carbon Monoxide | ##[[Carbon Monoxide]] | ||
##Metformin | ##Metformin | ||
##Didanosine | ##Didanosine | ||
| Line 46: | Line 46: | ||
##Hemlock | ##Hemlock | ||
##Depakote | ##Depakote | ||
##Hydrogen Sulfide | ##[[Hydrogen Sulfide]] | ||
##Nitroprusside (if cyanide toxic) | ##Nitroprusside (if cyanide toxic) | ||
##Ricin & Castor Beans | ##[[Ricin]] & Castor Beans | ||
##Propofol | ##Propofol | ||
##Sympathomimetics (cocaine, methamphetamine) | ##Sympathomimetics (cocaine, methamphetamine) | ||
Revision as of 06:44, 27 February 2014
Background
- Most common cause of metabolic acidosis in hospitalized patients
DDX by Type
- Type A
- Impaired tissue oxygenation
- Hypovolemia
- Cardiac failure
- Sepsis
- Carbon Monoxide poisoning
- Cyanide poisoning
- Impaired tissue oxygenation
- Type B
- No impaired tissue oxygenation
- Alcoholism
- Lactate utilization is impaired 2/2:
- 1. Impaired hepatic gluconeogenesis
- 2. No NAD+ to convert lactate to pyruvate
- Lactate utilization is impaired 2/2:
- Sepsis
- Liver disease
- Metformin
- Alcoholism
- No impaired tissue oxygenation
DDX Complete
- Any shock state
- Seizure
- Dead gut
- Hepatic failure
- Malignancy
- Exercise
- Use of b‐agonists
- Toxicologic Causes:
- Cyanide
- Carbon Monoxide
- Metformin
- Didanosine
- Stavudine
- Zidovudine
- Linezolid
- Strychnine
- Emtriva
- Rotenone (Fish Poison
- NaAzide (Lab Workers)
- Apap (if Liver Fx)
- Phospine (rodenticide)
- NaMonofluoroacetate (Coyote Poison‐ give Etoh as antidote)
- Inh (if patient seizes)
- Hemlock
- Depakote
- Hydrogen Sulfide
- Nitroprusside (if cyanide toxic)
- Ricin & Castor Beans
- Propofol
- Sympathomimetics (cocaine, methamphetamine)
- Jequirty peas (Abrus precatorius)
- Prunus Amygdalus plants
- Crab tree apple seeds & cassava (yucca)
Source
- Tintinalli
- EMCrit Podcast Acid-Base