Lactic acidosis: Difference between revisions
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*Most common cause of metabolic acidosis in hospitalized patients | *Most common cause of metabolic acidosis in hospitalized patients | ||
==DDX== | ==DDX by Type== | ||
*Type A | *Type A | ||
**Impaired tissue oxygenation | **Impaired tissue oxygenation | ||
| Line 19: | Line 19: | ||
***Liver disease | ***Liver disease | ||
***Metformin | ***Metformin | ||
==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== | ==Source== | ||
Tintinalli | *Tintinalli | ||
*EMCrit Podcast Acid-Base | |||
[[Category:FEN]] | [[Category:FEN]] | ||
[[Category:ID]] | [[Category:ID]] | ||
Revision as of 19:48, 3 August 2011
Background
- Most common cause of metabolic acidosis in hospitalized patients
DDX by Type
- Type A
- Impaired tissue oxygenation
- Hypovolemia
- Cardiac failure
- Sepsis
- CO poisoning
- CN 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