Metabolic alkalosis differential diagnosis: Difference between revisions

Latest revision as of 22:43, 29 July 2020

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sadaf Sharfaei M.D.[2]

Overview

Metabolic alkalosis might be consequence of several conditions such as exogenous HCO₃⁻ loads, medications and poisoning, gastrointestinal, renal, endocrine, and systemic diseases.

Metabolic Alkalosis

Differential diagnosis of metabolic alkalosis is as follow:

Category	Disease		Mechanism				Clinical						Paraclinical												Gold standard diagnosis	Other findings
							Symptoms			Signs			Lab data
							Symptoms			Signs			ABG			Chemistry					Enzyme	Renal function
			Hydrogen loss	Accumulation of base	Chloride depletion	Mineralocorticoid excess	Fever	Dyspnea	Edema	Toxic/ill	BP	Dehydration	HCO₃⁻	paCO₂	O₂	Cl⁻	K⁺	Na⁺	Ca⁺	Mg⁺	Renin	Bun	Cr	Urine Cl⁻
Exogenous HCO₃⁻ loads	Acute alkali administration^[1]		−	+	−	−	−	+	−	+	↓	−	↑	↑	↓	↓	↓	↓	↑	Nl	Nl	↑	↑	Nl	Clinical manifestations	Post treatment of lactic acidosis or ketoacidosis Increased risk of renal stones
	Milk−alkali syndrome^[2]		−	+	−	+	−	+	−	+	↓	+	↑	↑	↓	↓	↓	↓	↑	↓	↑	↑	↑	Nl	Clinical manifestationsk + exclusion of other causes of hypercalcemia	Ingestion of large amounts of calcium and absorbable alkali Acute kidney injury
	Transfusion^[3]		−	+	−	−	±	±	−	+	↓	−	↑	↑	↓	↓	↓/↑	↓	↓	↑	↑	Nl to ↑	Nl to ↑	Nl	History of administration of large quantities of blood products that contain sodium citrate	Associated with renal impairment
Drugs/Medication	Chloruretic diuretics^[4]	Bumetanide Chlorothiazide Metolazone	+	−	+	+	−	−	−	−	↓	+	↑	↑	Nl	↓	↓	↑	Nl	Nl	↑	Nl to ↑	Nl to ↑	↑	History of diuretic use	Contraction alkalosis
	Penicillin^[5]		+	−	−	−	−	−	−	−	Nl	−	↑	↑	Nl	↓	↓	↑	Nl	↓	↑	Nl	Nl	Nl	History of penicillin use	Not applicable
	Licorice^[6]^[7]		+	−	−	+	−	−	−	+	Nl to ↑	−	↑	↑	Nl	↓	↓	↑	Nl	Nl	↑	Nl to ↑	Nl to ↑	Nl	Clinical manifestations	Muscle weakness Paralysis
	Laxative abuse^[8]		+	−	+	−	−	−	±	+	↓	+	↑	↑	Nl	↓	↓	↑	Nl	↑	↑	Nl to ↑	Nl	↓	High level of suspicion	Large−volume, watery diarrhea Cramping abdominal pain Weight loss
	Antacids^[9]^[10]	Aluminum hydroxide Sodium polystyrene sulfonate	+	+	−	−	−	−	−	−	Nl	−	↑	↑	Nl	↓	↓	↑	Nl	↑	Nl	Nl to ↑	Nl to ↑	Nl	Clinical manifestations	Not applicable
Category	Disease		Hydrogen loss	Accumulation of base	Chloride depletion	Mineralocorticoid excess	Fever	Dyspnea	Edema	Toxic/ill	BP	Dehydration	HCO₃⁻	paCO₂	O₂	Cl⁻	K⁺	Na⁺	Ca⁺	Mg⁺	Renin	Bun	Cr	Urine Cl⁻	Gold standard diagnosis	Other findings
Gastrointestinal origin	Vomiting^[11]		+	−	+	−	±	−	−	+	↓	+	↑	↑	Nl	↓	↓	↑	Nl	Nl	↑	Nl to ↑	Nl	↓	Clinical manifestations	Not applicable
	Nasogastric tube suction^[12]		+	−	+	−	−	−	−	+	↓	+	↑	↑	Nl	↓	↓	↑	Nl	Nl	↑	Nl to ↑	Nl	↓	Clinical manifestations	GERD Pulmonary aspiration
	Zollinger−Ellison syndrome^[13]		+	−	+	−	−	−	−	+	↓	+	↑	↑	Nl	↓	↓	↑	Nl	Nl	↑	Nl to ↑	Nl	↓	Serum gastrin concentration + secretin stimulation test	Multiple or refractory peptic ulcers Chronic diarrhea MEN1
	Bulimia nervosa^[14]		+	−	+	−	−	−	±	+	↓	+	↑	↑	Nl	↓	↓	↓	Nl	↓	↑	Nl to ↑	Nl	↓	High level of suspicion	Lethargy Irregular menses Abdominal pain Constipation Salivary gland hypertrophy
	Congenital chloridorrhea^[15]		+	−	+	−	−	−	±	+	↓	+	↑	↑	Nl	↓	↓	↓	↓	↓	↑	Nl to ↑	Nl to ↑	Nl to ↑	Clinical manifestations+ lab findings	Profuse diarrhea Polyhydramnios
	Pyloric stenosis^[16]		+	−	+	−	−	−	−	+	↓	+	↑	↑	Nl	↓	↓	↓ ↑	Nl	Nl	↑	Nl to ↑	Nl	↓	Physical exam + imaging	Palpation of the “olive”
	Villous adenoma^[17]		+	−	+	−	−	−	−	+	↓	+	↑	↑	Nl	↓	↓	↓	↓	↓	↑	Nl to ↑	Nl	↑	Colonoscopy	Metabolic acidosis
	Gastrocystoplasty^[18]		−	−	+	−	−	−	+	−	↓	−	↑	↑	Nl	↓	Nl	Nl	Nl	Nl	Nl	Nl to ↑	Nl to ↑	Nl	History of operation	Hematuria−dysuria syndrome
Category	Disease		Hydrogen loss	Accumulation of base	Chloride depletion	Mineralocorticoid excess	Fever	Dyspnea	Edema	Toxic/ill	BP	Dehydration	HCO₃⁻	paCO₂	O₂	Cl⁻	K⁺	Na⁺	Ca⁺	Mg⁺	Renin	Bun	Cr	Urine Cl⁻	Gold standard diagnosis	Other findings
Renal origin	Posthypercapnic state^[19]		−	−	+	+	−	±	−	−	Nl	−	↑	↑↑	↓	↓	↓	↑	Nl	Nl	↑	Nl	Nl	Nl	Lab findings	Chronic respiratory acidosis
	Hypomagnesemia^[20]		+	−	−	−	−	−	−	−	Nl	−	↑	↑	Nl	↓	↓	↑	Nl	Nl	↑	Nl	Nl	Nl	Lab findings	Not applicable
	Hypokalemia^[21]		+	−	−	−	−	−	−	−	Nl	−	↑	↑	Nl	↓	↓	↑	Nl	Nl	↑	Nl	Nl	Nl	Lab findings	Not applicable
	Bartter's syndrome^[22]		+	−	−	+	−	−	−	−	Nl	+	↑	↑	Nl	↓	↓↓	↓	↓	Nl	↑	Nl to ↑	Nl to ↑	Nl	Genetic testing	Constipation Muscle cramps and weakness Failure to thrive Sensorineural deafness Focal segmental glomerulosclerosis Hypercalciuria
	Gitelman’s syndrome^[23]^[24]		+	−	−	+	−	−	−	−	↓	+	↑	↑	Nl	↓	↓↓	↓	Nl	↓	↑	Nl	Nl	Nl	Genetic testing	Less severe Constipation Muscle cramps and weakness Hypocalciuria
	Renal artery stenosis^[25]		+	−	+	−	−	+	+	+	↑	+	↑	↑	↓	↓	↑	↓	↑	Nl	↑	↑	↑	Nl	Clinical manifestations+ imaging	Chronic kidney disease Acute rise in Cr following ACEIs or ARBs
	Liddle syndrome^[26]		+	−	−	+	−	−	−	−	↑	+	↑	↑	Nl	↓	↓↓	↓	Nl	↓	↑	Nl	Nl	Nl	Genetic testing	Not applicable
	Renal tumors^[27]		+	−	+	−	−	+	+	+	↑	+	↑	↑	↓	↓	↑	↓	↑	Nl	↑	↑	↑	Nl	Biopsy	Not applicable
Endocrine	Cushing's syndrome^[28]		+	−	+	−	−	−	+	−	↑	+	↑	↑	Nl	↓	↑	↓	↑	Nl	↓	↑	↑	Nl	24−hour urinary cortisol excretion + low−dose dexamethasone suppression test	Obesity Lethargy Hirsutism Menstrual changes
	Hyperaldosteronism	Primary^[29]	+	−	+	−	−	−	+	−	↑	+	↑	↑	Nl	↓	Nl to ↓	↓	↑	Nl	↓	↑	↑	Nl	Lab findings	Resistant HTN Aldosterone−producing adenomas Bilateral adrenal hyperplasia
	Hyperaldosteronism	Secondary^[30]	+	−	+	−	−	+	+	+	↑	+	↑	↑	Nl	↓	↓	↑	Nl	↓	↑	↑	↑	Nl	Lab findings	Renin−producing tumor Renal artery stenosis Left ventricular heart failure Cor pulmonale Cirrhosis with ascites
	Congenital adrenal hyperplasia	11β−Hydroxylase deficiency^[31]	−	−	−	+	−	−	+	−	↑	+	↑	↑	Nl	↓	↓	↓	↑	Nl	↓	Nl	Nl	Nl	Genetic testing	Virilization Skin hyperpigmentation Bilateral adrenal gland enlargement
	Congenital adrenal hyperplasia	17α−Hydroxylase deficiency^[32]	−	−	−	+	−	−	+	−	↑	+	↑	↑	Nl	↓	↓	↓	↑	Nl	↓	Nl	Nl	Nl	Genetic testing	Ambiguous genitalia Undescended testes Lacks 2° sexual development Skin hyperpigmentation Bilateral adrenal gland enlargement
Systemic	Cystic fibrosis^[33]		+	−	+	−	−	+	−	+	↓	+	↑	↑	Nl	↓	↓	Nl	Nl	Nl	↑	Nl to ↑	Nl	↑	Genetic testing	Fatigue Persistent pulmonary infection Pancreatic insufficiency
Category	Disease		Hydrogen loss	Accumulation of base	Chloride depletion	Mineralocorticoid excess	Fever	Dyspnea	Edema	Toxic/ill	BP	Dehydration	HCO₃⁻	paCO₂	O₂	Cl⁻	K⁺	Na⁺	Ca⁺	Mg⁺	Renin	Bun	Cr	Urine Cl⁻	Gold standard diagnosis	Other findings

References

↑ Máttar, João A.; Weil, Max Harry; Shubin, Herbert; Stein, Leon (1974). "Cardiac arrest in the critically III". The American Journal of Medicine. 56 (2): 162–168. doi:10.1016/0002-9343(74)90593-2. ISSN 0002-9343.
↑ Abreo, Kenneth (1993). "The Milk-Alkali Syndrome". Archives of Internal Medicine. 153 (8): 1005. doi:10.1001/archinte.1993.00410080065011. ISSN 0003-9926.
↑ Gupta M, Wadhwa NK, Bukovsky R (January 2004). "Regional citrate anticoagulation for continuous venovenous hemodiafiltration using calcium-containing dialysate". Am. J. Kidney Dis. 43 (1): 67–73. PMID 14712429.
↑ Luke, R. G.; Galla, J. H. (2012). "It Is Chloride Depletion Alkalosis, Not Contraction Alkalosis". Journal of the American Society of Nephrology. 23 (2): 204–207. doi:10.1681/ASN.2011070720. ISSN 1046-6673.
↑ Zaki, SyedAhmed; Lad, Vijay (2011). "Piperacillin-tazobactam-induced hypokalemia and metabolic alkalosis". Indian Journal of Pharmacology. 43 (5): 609. doi:10.4103/0253-7613.84986. ISSN 0253-7613.
↑ Meltem, Akkas Camkurt; Figen, Coskun; Nalan, Metin Aksu; Mahir, Kunt; Sebnem, Bozkurt; Mehlika, Isildak; Kasim, Kilic Ahmet; Miyase, Bayraktar (2009). "A hypokalemic muscular weakness after licorice ingestion: a case report". Cases Journal. 2 (1): 8053. doi:10.4076/1757-1626-2-8053. ISSN 1757-1626.
↑ Lin, Shih-Hua; Yang, Sung-Sen; Chau, Tom; Halperin, Mitchell L. (2003). "An Unusual Cause of Hypokalemic Paralysis: Chronic Licorice Ingestion". The American Journal of the Medical Sciences. 325 (3): 153–156. doi:10.1097/00000441-200303000-00008. ISSN 0002-9629.
↑ Roerig, James L.; Steffen, Kristine J.; Mitchell, James E.; Zunker, Christie (2010). "Laxative Abuse". Drugs. 70 (12): 1487–1503. doi:10.2165/11898640-000000000-00000. ISSN 0012-6667.
↑ Sahani, Mandeep M.; Brennan, John F.; Nwakanma, Chukwuemeka; Chow, May T.; Ing, Todd S.; Leehey, David J. (2001). "Metabolic Alkalosis in a Hemodialysis Patient After Ingestion of a Large Amount of an Antacid Medication". Artificial Organs. 25 (4): 313–315. doi:10.1046/j.1525-1594.2001.06714.x. ISSN 0160-564X.
↑ Vanpee, Dominique; Delgrange, Etienne; Gillet, Jean-Bernard; Donckier, Julian (2000). "Ingestion of antacid tablets (Rennie®) and acute confusion". The Journal of Emergency Medicine. 19 (2): 169–171. doi:10.1016/S0736-4679(00)00206-7. ISSN 0736-4679.
↑ Gan, Tong J.; Meyer, Tricia; Apfel, Christian C.; Chung, Frances; Davis, Peter J.; Eubanks, Steve; Kovac, Anthony; Philip, Beverly K.; Sessler, Daniel I.; Temo, James; Tram??r, Martin R.; Watcha, Mehernoor (2003). "Consensus Guidelines for Managing Postoperative Nausea and Vomiting". Anesthesia & Analgesia: 62–71. doi:10.1213/01.ANE.0000068580.00245.95. ISSN 0003-2999.
↑ Gilbertson, Heather Ruth; Rogers, Elizabeth Jessie; Ukoumunne, Obioha Chukwunyere (2011). "Determination of a Practical pH Cutoff Level for Reliable Confirmation of Nasogastric Tube Placement". Journal of Parenteral and Enteral Nutrition. 35 (4): 540–544. doi:10.1177/0148607110383285. ISSN 0148-6071.
↑ Hung, Patrick D.; Schubert, Mitchell L.; Mihas, Anastasios A. (2003). "Zollinger-Ellison syndrome". Current Treatment Options in Gastroenterology. 6 (2): 163–170. doi:10.1007/s11938-003-0017-6. ISSN 1092-8472.
↑ Shapiro, Jennifer R.; Berkman, Nancy D.; Brownley, Kimberly A.; Sedway, Jan A.; Lohr, Kathleen N.; Bulik, Cynthia M. (2007). "Bulimia nervosa treatment: A systematic review of randomized controlled trials". International Journal of Eating Disorders. 40 (4): 321–336. doi:10.1002/eat.20372. ISSN 0276-3478.
↑ Wedenoja, S.; HãGlund, P.; Holmberg, C. (2010). "Review article: the clinical management of congenital chloride diarrhoea". Alimentary Pharmacology & Therapeutics. 31 (4): 477–485. doi:10.1111/j.1365-2036.2009.04197.x. ISSN 0269-2813. C1 control character in |last2= at position 3 (help)
↑ Bakal, Unal; Sarac, Mehmet; Aydin, Mustafa; Tartar, Tugay; Kazez, Ahmet (2016). "Recent changes in the features of hypertrophic pyloric stenosis". Pediatrics International. 58 (5): 369–371. doi:10.1111/ped.12860. ISSN 1328-8067.
↑ Gennari, F. J.; Weise, W. J. (2008). "Acid-Base Disturbances in Gastrointestinal Disease". Clinical Journal of the American Society of Nephrology. 3 (6): 1861–1868. doi:10.2215/CJN.02450508. ISSN 1555-9041.
↑ Kurzrock, Eric A.; Baskin, Laurence S.; Kogan, Barry A. (1998). "GASTROCYSTOPLASTY: LONG-TERM FOLLOWUP". The Journal of Urology. 160 (6): 2182–2186. doi:10.1016/S0022-5347(01)62289-4. ISSN 0022-5347.
↑ Banga, Amit; Khilnani, G. C. (2009). "Post-hypercapnic Alkalosis is Associated with Ventilator Dependence and Increased ICU stay". COPD: Journal of Chronic Obstructive Pulmonary Disease. 6 (6): 437–440. doi:10.3109/15412550903341448. ISSN 1541-2555.
↑ Elisaf M, Milionis H, Siamopoulos KC (1997). "Hypomagnesemic hypokalemia and hypocalcemia: clinical and laboratory characteristics". Miner Electrolyte Metab. 23 (2): 105–12. PMID 9252977.
↑ Galla JH (February 2000). "Metabolic alkalosis". J. Am. Soc. Nephrol. 11 (2): 369–75. PMID 10665945.
↑ Simon, David B.; Karet, Fiona E.; Hamdan, Jahed M.; Pietro, Antonio Di; Sanjad, Sami A.; Lifton, Richard P. (1996). "Bartter's syndrome, hypokalaemic alkalosis with hypercalciuria, is caused by mutations in the Na–K–2CI cotransporter NKCC2". Nature Genetics. 13 (2): 183–188. doi:10.1038/ng0696-183. ISSN 1061-4036.
↑ Fremont, Oliver T.; Chan, James C. M. (2012). "Understanding Bartter syndrome and Gitelman syndrome". World Journal of Pediatrics. 8 (1): 25–30. doi:10.1007/s12519-012-0333-9. ISSN 1708-8569.
↑ Colussi G, Macaluso M, Brunati C, Minetti L (1994). "Calcium metabolism and calciotropic hormone levels in Gitelman's syndrome". Miner Electrolyte Metab. 20 (5): 294–301. PMID 7700218.
↑ Safian, Robert D.; Textor, Stephen C. (2001). "Renal-Artery Stenosis". New England Journal of Medicine. 344 (6): 431–442. doi:10.1056/NEJM200102083440607. ISSN 0028-4793.
↑ Salih, Mahdi; Gautschi, Ivan; van Bemmelen, Miguel X.; Di Benedetto, Michael; Brooks, Alice S.; Lugtenberg, Dorien; Schild, Laurent; Hoorn, Ewout J. (2017). "A Missense Mutation in the Extracellular Domain ofαENaC Causes Liddle Syndrome". Journal of the American Society of Nephrology. 28 (11): 3291–3299. doi:10.1681/ASN.2016111163. ISSN 1046-6673.
↑ Lasseigne, Brittany N.; Brooks, James D. (2018). "The Role of DNA Methylation in Renal Cell Carcinoma". Molecular Diagnosis & Therapy. doi:10.1007/s40291-018-0337-9. ISSN 1177-1062.
↑ Araujo Castro, Marta; Marazuela Azpiroz, Mónica (2018). "Two types of ectopic Cushing syndrome or a continuum? Review". Pituitary. doi:10.1007/s11102-018-0894-2. ISSN 1386-341X.
↑ Martell-Claros, Nieves; Abad-Cardiel, María; Alvarez-Alvarez, Beatriz; García-Donaire, José A.; Pérez, Cristina Fernández (2015). "Primary aldosteronism and its various clinical scenarios". Journal of Hypertension. 33 (6): 1226–1232. doi:10.1097/HJH.0000000000000546. ISSN 0263-6352.
↑ Monticone S, Losano I, Tetti M, Buffolo F, Veglio F, Mulatero P (May 2018). "Diagnostic approach to low renin hypertension". Clin. Endocrinol. (Oxf). doi:10.1111/cen.13741. PMID 29758100.
↑ Baş F, Toksoy G, Ergun-Longmire B, Uyguner ZO, Abalı ZY, Poyrazoğlu Ş, Karaman V, Avcı Ş, Altunoğlu U, Bundak R, Karaman B, Başaran S, Darendeliler F (April 2018). "Prevalence, clinical characteristics and long-term outcomes of classical 11 β-hydroxylase deficiency (11BOHD) in Turkish population and novel mutations in CYP11B1 gene". J. Steroid Biochem. Mol. Biol. doi:10.1016/j.jsbmb.2018.04.001. PMID 29626607.
↑ Goldsmith, Oliver; Solomon, David H.; Horton, Richard (1967). "Hypogonadism and Mineralocorticoid Excess". New England Journal of Medicine. 277 (13): 673–677. doi:10.1056/NEJM196709282771302. ISSN 0028-4793.
↑ Bates CM, Baum M, Quigley R (February 1997). "Cystic fibrosis presenting with hypokalemia and metabolic alkalosis in a previously healthy adolescent". J. Am. Soc. Nephrol. 8 (2): 352–5. PMID 9048354.

[MáttarWeil1974-1] Máttar, João A.; Weil, Max Harry; Shubin, Herbert; Stein, Leon (1974). "Cardiac arrest in the critically III". The American Journal of Medicine. 56 (2): 162–168. doi:10.1016/0002-9343(74)90593-2. ISSN 0002-9343.

[Abreo1993-2] Abreo, Kenneth (1993). "The Milk-Alkali Syndrome". Archives of Internal Medicine. 153 (8): 1005. doi:10.1001/archinte.1993.00410080065011. ISSN 0003-9926.

[pmid14712429-3] Gupta M, Wadhwa NK, Bukovsky R (January 2004). "Regional citrate anticoagulation for continuous venovenous hemodiafiltration using calcium-containing dialysate". Am. J. Kidney Dis. 43 (1): 67–73. PMID 14712429.

[LukeGalla2012-4] Luke, R. G.; Galla, J. H. (2012). "It Is Chloride Depletion Alkalosis, Not Contraction Alkalosis". Journal of the American Society of Nephrology. 23 (2): 204–207. doi:10.1681/ASN.2011070720. ISSN 1046-6673.

[ZakiLad2011-5] Zaki, SyedAhmed; Lad, Vijay (2011). "Piperacillin-tazobactam-induced hypokalemia and metabolic alkalosis". Indian Journal of Pharmacology. 43 (5): 609. doi:10.4103/0253-7613.84986. ISSN 0253-7613.

[MeltemFigen2009-6] Meltem, Akkas Camkurt; Figen, Coskun; Nalan, Metin Aksu; Mahir, Kunt; Sebnem, Bozkurt; Mehlika, Isildak; Kasim, Kilic Ahmet; Miyase, Bayraktar (2009). "A hypokalemic muscular weakness after licorice ingestion: a case report". Cases Journal. 2 (1): 8053. doi:10.4076/1757-1626-2-8053. ISSN 1757-1626.

[LinYang2003-7] Lin, Shih-Hua; Yang, Sung-Sen; Chau, Tom; Halperin, Mitchell L. (2003). "An Unusual Cause of Hypokalemic Paralysis: Chronic Licorice Ingestion". The American Journal of the Medical Sciences. 325 (3): 153–156. doi:10.1097/00000441-200303000-00008. ISSN 0002-9629.

[RoerigSteffen2010-8] Roerig, James L.; Steffen, Kristine J.; Mitchell, James E.; Zunker, Christie (2010). "Laxative Abuse". Drugs. 70 (12): 1487–1503. doi:10.2165/11898640-000000000-00000. ISSN 0012-6667.

[SahaniBrennan2001-9] Sahani, Mandeep M.; Brennan, John F.; Nwakanma, Chukwuemeka; Chow, May T.; Ing, Todd S.; Leehey, David J. (2001). "Metabolic Alkalosis in a Hemodialysis Patient After Ingestion of a Large Amount of an Antacid Medication". Artificial Organs. 25 (4): 313–315. doi:10.1046/j.1525-1594.2001.06714.x. ISSN 0160-564X.

[VanpeeDelgrange2000-10] Vanpee, Dominique; Delgrange, Etienne; Gillet, Jean-Bernard; Donckier, Julian (2000). "Ingestion of antacid tablets (Rennie®) and acute confusion". The Journal of Emergency Medicine. 19 (2): 169–171. doi:10.1016/S0736-4679(00)00206-7. ISSN 0736-4679.

[GanMeyer2003-11] Gan, Tong J.; Meyer, Tricia; Apfel, Christian C.; Chung, Frances; Davis, Peter J.; Eubanks, Steve; Kovac, Anthony; Philip, Beverly K.; Sessler, Daniel I.; Temo, James; Tram??r, Martin R.; Watcha, Mehernoor (2003). "Consensus Guidelines for Managing Postoperative Nausea and Vomiting". Anesthesia & Analgesia: 62–71. doi:10.1213/01.ANE.0000068580.00245.95. ISSN 0003-2999.

[GilbertsonRogers2011-12] Gilbertson, Heather Ruth; Rogers, Elizabeth Jessie; Ukoumunne, Obioha Chukwunyere (2011). "Determination of a Practical pH Cutoff Level for Reliable Confirmation of Nasogastric Tube Placement". Journal of Parenteral and Enteral Nutrition. 35 (4): 540–544. doi:10.1177/0148607110383285. ISSN 0148-6071.

[HungSchubert2003-13] Hung, Patrick D.; Schubert, Mitchell L.; Mihas, Anastasios A. (2003). "Zollinger-Ellison syndrome". Current Treatment Options in Gastroenterology. 6 (2): 163–170. doi:10.1007/s11938-003-0017-6. ISSN 1092-8472.

[ShapiroBerkman2007-14] Shapiro, Jennifer R.; Berkman, Nancy D.; Brownley, Kimberly A.; Sedway, Jan A.; Lohr, Kathleen N.; Bulik, Cynthia M. (2007). "Bulimia nervosa treatment: A systematic review of randomized controlled trials". International Journal of Eating Disorders. 40 (4): 321–336. doi:10.1002/eat.20372. ISSN 0276-3478.

[WedenojaHãGlund2010-15] Wedenoja, S.; HãGlund, P.; Holmberg, C. (2010). "Review article: the clinical management of congenital chloride diarrhoea". Alimentary Pharmacology & Therapeutics. 31 (4): 477–485. doi:10.1111/j.1365-2036.2009.04197.x. ISSN 0269-2813. C1 control character in |last2= at position 3 (help)

[BakalSarac2016-16] Bakal, Unal; Sarac, Mehmet; Aydin, Mustafa; Tartar, Tugay; Kazez, Ahmet (2016). "Recent changes in the features of hypertrophic pyloric stenosis". Pediatrics International. 58 (5): 369–371. doi:10.1111/ped.12860. ISSN 1328-8067.

[GennariWeise2008-17] Gennari, F. J.; Weise, W. J. (2008). "Acid-Base Disturbances in Gastrointestinal Disease". Clinical Journal of the American Society of Nephrology. 3 (6): 1861–1868. doi:10.2215/CJN.02450508. ISSN 1555-9041.

[KurzrockBaskin1998-18] Kurzrock, Eric A.; Baskin, Laurence S.; Kogan, Barry A. (1998). "GASTROCYSTOPLASTY: LONG-TERM FOLLOWUP". The Journal of Urology. 160 (6): 2182–2186. doi:10.1016/S0022-5347(01)62289-4. ISSN 0022-5347.

[BangaKhilnani2009-19] Banga, Amit; Khilnani, G. C. (2009). "Post-hypercapnic Alkalosis is Associated with Ventilator Dependence and Increased ICU stay". COPD: Journal of Chronic Obstructive Pulmonary Disease. 6 (6): 437–440. doi:10.3109/15412550903341448. ISSN 1541-2555.

[pmid9252977-20] Elisaf M, Milionis H, Siamopoulos KC (1997). "Hypomagnesemic hypokalemia and hypocalcemia: clinical and laboratory characteristics". Miner Electrolyte Metab. 23 (2): 105–12. PMID 9252977.

[pmid10665945-21] Galla JH (February 2000). "Metabolic alkalosis". J. Am. Soc. Nephrol. 11 (2): 369–75. PMID 10665945.

[SimonKaret1996-22] Simon, David B.; Karet, Fiona E.; Hamdan, Jahed M.; Pietro, Antonio Di; Sanjad, Sami A.; Lifton, Richard P. (1996). "Bartter's syndrome, hypokalaemic alkalosis with hypercalciuria, is caused by mutations in the Na–K–2CI cotransporter NKCC2". Nature Genetics. 13 (2): 183–188. doi:10.1038/ng0696-183. ISSN 1061-4036.

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@@ Line 1: / Line 1: @@
 __NOTOC__
-{{Metabolic alkalosis}}
+[[Image:Home_logo1.png|right|250px|link=https://www.wikidoc.org/index.php/Metabolic_alkalosis]]
-{{CMG}}; {{AE}}
+{{CMG}}; {{AE}}{{SSH}}
 ==Overview==
-[Disease name] must be differentiated from other diseases that cause [clinical feature 1], [clinical feature 2], and [clinical feature 3], such as [differential dx1], [differential dx2], and [differential dx3].
+Metabolic alkalosis might be consequence of several conditions such as exogenous [[Bicarbonate|HCO<sub><big>3</big></sub>]]<sup>−</sup> loads, [[Medication|medications]] and [[Poison|poisoning]], [[Gastrointestinal tract|gastrointestinal]], [[Kidney|renal]], [[Endocrine system|endocrine]], and systemic diseases.
-OR
+== Metabolic Alkalosis ==
+'''''Differential diagnosis of metabolic alkalosis is as follow''''':
+{|
+! rowspan="4" align="center" style="background:#4479BA; color: #FFFFFF;" + |Category
+! colspan="2" rowspan="4" align="center" style="background:#4479BA; color: #FFFFFF;" + |Disease
+! colspan="4" rowspan="3" align="center" style="background:#4479BA; color: #FFFFFF;" + |Mechanism
+! colspan="6" align="center" style="background:#4479BA; color: #FFFFFF;" + |Clinical
+! colspan="12" align="center" style="background:#4479BA; color: #FFFFFF;" + |Paraclinical
+! rowspan="4" align="center" style="background:#4479BA; color: #FFFFFF;" + |Gold standard diagnosis
+! rowspan="4" align="center" style="background:#4479BA; color: #FFFFFF;" + |Other findings
+|-
+! colspan="3" rowspan="2" align="center" style="background:#4479BA; color: #FFFFFF;" + |Symptoms
+! colspan="3" rowspan="2" align="center" style="background:#4479BA; color: #FFFFFF;" + |Signs
+! colspan="12" align="center" style="background:#4479BA; color: #FFFFFF;" + |Lab data
+|-
+! colspan="3" align="center" style="background:#4479BA; color: #FFFFFF;" + |ABG
+! colspan="5" align="center" style="background:#4479BA; color: #FFFFFF;" + |Chemistry
+! align="center" style="background:#4479BA; color: #FFFFFF;" + |Enzyme
+! colspan="3" align="center" style="background:#4479BA; color: #FFFFFF;" + |Renal function
+|-
+! align="center" style="background:#4479BA; color: #FFFFFF;" + |Hydrogen loss
+! align="center" style="background:#4479BA; color: #FFFFFF;" + |Accumulation of base
+! align="center" style="background:#4479BA; color: #FFFFFF;" + |Chloride depletion
+! align="center" style="background:#4479BA; color: #FFFFFF;" + |Mineralocorticoid excess
+! align="center" style="background:#4479BA; color: #FFFFFF;" + |Fever
+! align="center" style="background:#4479BA; color: #FFFFFF;" + |Dyspnea
+! align="center" style="background:#4479BA; color: #FFFFFF;" + |Edema
+! align="center" style="background:#4479BA; color: #FFFFFF;" + |Toxic/ill
+! align="center" style="background:#4479BA; color: #FFFFFF;" + |BP
+! align="center" style="background:#4479BA; color: #FFFFFF;" + |Dehydration
+! align="center" style="background:#4479BA; color: #FFFFFF;" + |HCO<sub>3</sub><sup>−</sup>
+! align="center" style="background:#4479BA; color: #FFFFFF;" + |paCO<sub>2</sub>
+! align="center" style="background:#4479BA; color: #FFFFFF;" + |O<sub>2</sub>
+! align="center" style="background:#4479BA; color: #FFFFFF;" + |Cl<sup>−</sup>
+! align="center" style="background:#4479BA; color: #FFFFFF;" + |K<sup>+</sup>
+! align="center" style="background:#4479BA; color: #FFFFFF;" + |Na<sup>+</sup>
+! align="center" style="background:#4479BA; color: #FFFFFF;" + |Ca<sup>+</sup>
+! align="center" style="background:#4479BA; color: #FFFFFF;" + |Mg<sup>+</sup>
+! align="center" style="background:#4479BA; color: #FFFFFF;" + |Renin
+! align="center" style="background:#4479BA; color: #FFFFFF;" + |Bun
+! align="center" style="background:#4479BA; color: #FFFFFF;" + |Cr
+! align="center" style="background:#4479BA; color: #FFFFFF;" + |Urine Cl<sup>−</sup>
+|-
+! rowspan="3" align="center" style="background:#4479BA; color: #FFFFFF;" + |Exogenous HCO<sub><big>3</big></sub><sup>−</sup> loads
+! colspan="2" align="center" style="background:#DCDCDC;" + |Acute alkali administration<ref name="MáttarWeil1974">{{cite journal|last1=Máttar|first1=João A.|last2=Weil|first2=Max Harry|last3=Shubin|first3=Herbert|last4=Stein|first4=Leon|title=Cardiac arrest in the critically III|journal=The American Journal of Medicine|volume=56|issue=2|year=1974|pages=162–168|issn=00029343|doi=10.1016/0002-9343(74)90593-2}}</ref>
+| align="center" style="background:#F5F5F5;" + |−
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + |−
+| align="center" style="background:#F5F5F5;" + |−
+| align="center" style="background:#F5F5F5;" + | −
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + |−
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + |↓
+| align="center" style="background:#F5F5F5;" + | −
+| align="center" style="background:#F5F5F5;" + |↑
+| align="center" style="background:#F5F5F5;" + |↑
+| align="center" style="background:#F5F5F5;" + |↓
+| align="center" style="background:#F5F5F5;" + |↓
+| align="center" style="background:#F5F5F5;" + |↓
+| align="center" style="background:#F5F5F5;" + |↓
+| align="center" style="background:#F5F5F5;" + |↑
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + |↑
+| align="center" style="background:#F5F5F5;" + |↑
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + |Clinical manifestations
+| align="left" style="background:#F5F5F5;" + |
+* Post treatment of [[lactic acidosis]] or [[ketoacidosis]]
+* Increased risk of [[Kidney stone|renal stones]]
+|-
+! colspan="2" align="center" style="background:#DCDCDC;" + |[[Milk-alkali syndrome|Milk−alkali syndrome]]<ref name="Abreo1993">{{cite journal|last1=Abreo|first1=Kenneth|title=The Milk-Alkali Syndrome|journal=Archives of Internal Medicine|volume=153|issue=8|year=1993|pages=1005|issn=0003-9926|doi=10.1001/archinte.1993.00410080065011}}</ref>
+| align="center" style="background:#F5F5F5;" + |−
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + | −
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + | −
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + |−
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + |↓
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + |↑
+| align="center" style="background:#F5F5F5;" + |↑
+| align="center" style="background:#F5F5F5;" + |↓
+| align="center" style="background:#F5F5F5;" + |↓
+| align="center" style="background:#F5F5F5;" + |↓
+| align="center" style="background:#F5F5F5;" + |↓
+| align="center" style="background:#F5F5F5;" + |↑
+| align="center" style="background:#F5F5F5;" + |↓
+| align="center" style="background:#F5F5F5;" + |↑
+| align="center" style="background:#F5F5F5;" + |↑
+| align="center" style="background:#F5F5F5;" + |↑
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + |Clinical manifestationsk + exclusion of other causes of [[hypercalcemia]]
+| align="left" style="background:#F5F5F5;" + |
+* Ingestion of large amounts of calcium and absorbable alkali
+* [[Acute kidney injury]]
+|-
+! colspan="2" align="center" style="background:#DCDCDC;" + |[[Transfusion]]<ref name="pmid14712429">{{cite journal |vauthors=Gupta M, Wadhwa NK, Bukovsky R |title=Regional citrate anticoagulation for continuous venovenous hemodiafiltration using calcium-containing dialysate |journal=Am. J. Kidney Dis. |volume=43 |issue=1 |pages=67–73 |date=January 2004 |pmid=14712429 |doi= |url=}}</ref>
+| align="center" style="background:#F5F5F5;" + | −
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + | −
+| align="center" style="background:#F5F5F5;" + | −
+| align="center" style="background:#F5F5F5;" + |±
+| align="center" style="background:#F5F5F5;" + |±
+| align="center" style="background:#F5F5F5;" + | −
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + |↓
+| align="center" style="background:#F5F5F5;" + | −
+| align="center" style="background:#F5F5F5;" + |↑
+| align="center" style="background:#F5F5F5;" + |↑
+| align="center" style="background:#F5F5F5;" + |↓
+| align="center" style="background:#F5F5F5;" + |↓
+| align="center" style="background:#F5F5F5;" + |↓/↑
+| align="center" style="background:#F5F5F5;" + |↓
+| align="center" style="background:#F5F5F5;" + |↓
+| align="center" style="background:#F5F5F5;" + |↑
+| align="center" style="background:#F5F5F5;" + |↑
+| align="center" style="background:#F5F5F5;" + |Nl to ↑
+| align="center" style="background:#F5F5F5;" + |Nl to ↑
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + |History of administration of large quantities of [[blood]] products that contain [[sodium citrate]]
+| align="left" style="background:#F5F5F5;" + |
+* Associated with [[Renal insufficiency|renal impairment]]
+|-
+! rowspan="5" align="center" style="background:#4479BA; color: #FFFFFF;" + |Drugs/Medication
+! align="center" style="background:#DCDCDC;" + |[[Diuretics|Chloruretic diuretics]]<ref name="LukeGalla2012">{{cite journal|last1=Luke|first1=R. G.|last2=Galla|first2=J. H.|title=It Is Chloride Depletion Alkalosis, Not Contraction Alkalosis|journal=Journal of the American Society of Nephrology|volume=23|issue=2|year=2012|pages=204–207|issn=1046-6673|doi=10.1681/ASN.2011070720}}</ref>
+! align="left" style="background:#DCDCDC;" + |
+* [[Bumetanide]]
+* [[Chlorothiazide]]
+* [[Metolazone]]
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + |−
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + |−
+| align="center" style="background:#F5F5F5;" + |−
+| align="center" style="background:#F5F5F5;" + |−
+| align="center" style="background:#F5F5F5;" + |−
+| align="center" style="background:#F5F5F5;" + |↓
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + |↑
+| align="center" style="background:#F5F5F5;" + |↑
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + |↓
+| align="center" style="background:#F5F5F5;" + |↓
+| align="center" style="background:#F5F5F5;" + |↑
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + |↑
+| align="center" style="background:#F5F5F5;" + |Nl to ↑
+| align="center" style="background:#F5F5F5;" + |Nl to ↑
+| align="center" style="background:#F5F5F5;" + |↑
+| align="center" style="background:#F5F5F5;" + |History of diuretic use
+| align="left" style="background:#F5F5F5;" + |
+* [[Contraction alkalosis]]
+|-
+! colspan="2" align="center" style="background:#DCDCDC;" + |[[Penicillin]]<ref name="ZakiLad2011">{{cite journal|last1=Zaki|first1=SyedAhmed|last2=Lad|first2=Vijay|title=Piperacillin-tazobactam-induced hypokalemia and metabolic alkalosis|journal=Indian Journal of Pharmacology|volume=43|issue=5|year=2011|pages=609|issn=0253-7613|doi=10.4103/0253-7613.84986}}</ref>
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + |−
+| align="center" style="background:#F5F5F5;" + |−
+| align="center" style="background:#F5F5F5;" + |−
+| align="center" style="background:#F5F5F5;" + |−
+| align="center" style="background:#F5F5F5;" + |−
+| align="center" style="background:#F5F5F5;" + |−
+| align="center" style="background:#F5F5F5;" + |−
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + |−
+| align="center" style="background:#F5F5F5;" + |↑
+| align="center" style="background:#F5F5F5;" + |↑
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + |↓
+| align="center" style="background:#F5F5F5;" + |↓
+| align="center" style="background:#F5F5F5;" + |↑
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + |↓
+| align="center" style="background:#F5F5F5;" + |↑
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + |History of penicillin use
+| align="left" style="background:#F5F5F5;" + |
+* Not applicable
+|-
+! colspan="2" align="center" style="background:#DCDCDC;" + |Licorice<ref name="MeltemFigen2009">{{cite journal|last1=Meltem|first1=Akkas Camkurt|last2=Figen|first2=Coskun|last3=Nalan|first3=Metin Aksu|last4=Mahir|first4=Kunt|last5=Sebnem|first5=Bozkurt|last6=Mehlika|first6=Isildak|last7=Kasim|first7=Kilic Ahmet|last8=Miyase|first8=Bayraktar|title=A hypokalemic muscular weakness after licorice ingestion: a case report|journal=Cases Journal|volume=2|issue=1|year=2009|pages=8053|issn=1757-1626|doi=10.4076/1757-1626-2-8053}}</ref><ref name="LinYang2003">{{cite journal|last1=Lin|first1=Shih-Hua|last2=Yang|first2=Sung-Sen|last3=Chau|first3=Tom|last4=Halperin|first4=Mitchell L.|title=An Unusual Cause of Hypokalemic Paralysis: Chronic Licorice Ingestion|journal=The American Journal of the Medical Sciences|volume=325|issue=3|year=2003|pages=153–156|issn=00029629|doi=10.1097/00000441-200303000-00008}}</ref>
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + |−
+| align="center" style="background:#F5F5F5;" + |−
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + |−
+| align="center" style="background:#F5F5F5;" + |−
+| align="center" style="background:#F5F5F5;" + |−
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + |Nl to ↑
+| align="center" style="background:#F5F5F5;" + |−
+| align="center" style="background:#F5F5F5;" + |↑
+| align="center" style="background:#F5F5F5;" + |↑
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + |↓
+| align="center" style="background:#F5F5F5;" + |↓
+| align="center" style="background:#F5F5F5;" + |↑
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + |↑
+| align="center" style="background:#F5F5F5;" + |Nl to ↑
+| align="center" style="background:#F5F5F5;" + |Nl to ↑
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + |Clinical  manifestations
+| align="left" style="background:#F5F5F5;" + |
+* [[Muscle weakness]]
-[Disease name] must be differentiated from [[differential dx1], [differential dx2], and [differential dx3].
+* [[Paralysis]]
+|-
-==Differentiating X from other Diseases==
+! colspan="2" align="center" style="background:#DCDCDC;" + |[[Laxative abuse]]<ref name="RoerigSteffen2010">{{cite journal|last1=Roerig|first1=James L.|last2=Steffen|first2=Kristine J.|last3=Mitchell|first3=James E.|last4=Zunker|first4=Christie|title=Laxative Abuse|journal=Drugs|volume=70|issue=12|year=2010|pages=1487–1503|issn=0012-6667|doi=10.2165/11898640-000000000-00000}}</ref>
-*[Disease name] must be differentiated from other diseases that cause [clinical feature 1], [clinical feature 2], and [clinical feature 3], such as [differential dx1], [differential dx2], and [differential dx3].
+| align="center" style="background:#F5F5F5;" + | +
-*[Disease name] must be differentiated from [differential dx1], [differential dx2], and [differential dx3].
+| align="center" style="background:#F5F5F5;" + |−
+| align="center" style="background:#F5F5F5;" + | +
-*As [disease name] manifests in a variety of clinical forms, differentiation must be established in accordance with the particular subtype. [Subtype name 1] must be differentiated from other diseases that cause [clinical feature 1], such as [differential dx1] and [differential dx2]. In contrast, [subtype name 2] must be differentiated from other diseases that cause [clinical feature 2], such as [differential dx3] and [differential dx4].
+| align="center" style="background:#F5F5F5;" + |−
+| align="center" style="background:#F5F5F5;" + | −
-===Preferred Table===
+| align="center" style="background:#F5F5F5;" + |−
-{|
+| align="center" style="background:#F5F5F5;" + |±
-|- style="background: #4479BA; color: #FFFFFF; text-align: center;"
+| align="center" style="background:#F5F5F5;" + | +
-! rowspan="4"  style="background: #4479BA; color: #FFFFFF; text-align: center;|Diseases
+| align="center" style="background:#F5F5F5;" + |↓
-| colspan="6" rowspan="1"  style="background: #4479BA; color: #FFFFFF; text-align: center;|'''Clinical manifestations'''
+| align="center" style="background:#F5F5F5;" + | +
-! colspan="7" rowspan="2"  style="background: #4479BA; color: #FFFFFF; text-align: center;|Para-clinical findings
+| align="center" style="background:#F5F5F5;" + |↑
-| colspan="1" rowspan="4"  style="background: #4479BA; color: #FFFFFF; text-align: center;|'''Gold standard'''
+| align="center" style="background:#F5F5F5;" + |↑
-! rowspan="4" style="background: #4479BA; color: #FFFFFF; text-align: center;|Additional findings
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + |↓
+| align="center" style="background:#F5F5F5;" + |↓
+| align="center" style="background:#F5F5F5;" + |↑
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + |↑
+| align="center" style="background:#F5F5F5;" + |↑
+| align="center" style="background:#F5F5F5;" + |Nl to ↑
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + |↓
+| align="center" style="background:#F5F5F5;" + |High level of suspicion
+| align="left" style="background:#F5F5F5;" + |
+* Large−volume, [[Diarrhea|watery diarrhea]]
+* Cramping [[abdominal pain]]
+* [[Weight loss]]
+|-
+! align="center" style="background:#DCDCDC;" + |[[Antacids]]<ref name="SahaniBrennan2001">{{cite journal|last1=Sahani|first1=Mandeep M.|last2=Brennan|first2=John F.|last3=Nwakanma|first3=Chukwuemeka|last4=Chow|first4=May T.|last5=Ing|first5=Todd S.|last6=Leehey|first6=David J.|title=Metabolic Alkalosis in a Hemodialysis Patient After Ingestion of a Large Amount of an Antacid Medication|journal=Artificial Organs|volume=25|issue=4|year=2001|pages=313–315|issn=0160-564X|doi=10.1046/j.1525-1594.2001.06714.x}}</ref><ref name="VanpeeDelgrange2000">{{cite journal|last1=Vanpee|first1=Dominique|last2=Delgrange|first2=Etienne|last3=Gillet|first3=Jean-Bernard|last4=Donckier|first4=Julian|title=Ingestion of antacid tablets (Rennie®) and acute confusion|journal=The Journal of Emergency Medicine|volume=19|issue=2|year=2000|pages=169–171|issn=07364679|doi=10.1016/S0736-4679(00)00206-7}}</ref>
+! align="left" style="background:#DCDCDC;" + |
+* Aluminum hydroxide
+* Sodium polystyrene sulfonate
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + | −
+| align="center" style="background:#F5F5F5;" + | −
+| align="center" style="background:#F5F5F5;" + | −
+| align="center" style="background:#F5F5F5;" + | −
+| align="center" style="background:#F5F5F5;" + | −
+| align="center" style="background:#F5F5F5;" + | −
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + | −
+| align="center" style="background:#F5F5F5;" + |↑
+| align="center" style="background:#F5F5F5;" + |↑
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + |↓
+| align="center" style="background:#F5F5F5;" + |↓
+| align="center" style="background:#F5F5F5;" + |↑
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + |↑
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + |Nl to ↑
+| align="center" style="background:#F5F5F5;" + |Nl to ↑
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + |Clinical  manifestations
+| align="left" style="background:#F5F5F5;" + |
+* Not applicable
+|-
+! align="center" style="background:#4479BA; color: #FFFFFF;" + |Category
+! colspan="2" align="center" style="background:#4479BA; color: #FFFFFF;" + |Disease
+! align="center" style="background:#4479BA; color: #FFFFFF;" + |Hydrogen loss
+! align="center" style="background:#4479BA; color: #FFFFFF;" + |Accumulation of base
+! align="center" style="background:#4479BA; color: #FFFFFF;" + |Chloride depletion
+! align="center" style="background:#4479BA; color: #FFFFFF;" + |Mineralocorticoid excess
+! align="center" style="background:#4479BA; color: #FFFFFF;" + |Fever
+! align="center" style="background:#4479BA; color: #FFFFFF;" + |Dyspnea
+! align="center" style="background:#4479BA; color: #FFFFFF;" + |Edema
+! align="center" style="background:#4479BA; color: #FFFFFF;" + |Toxic/ill
+! align="center" style="background:#4479BA; color: #FFFFFF;" + |BP
+! align="center" style="background:#4479BA; color: #FFFFFF;" + |Dehydration
+! align="center" style="background:#4479BA; color: #FFFFFF;" + |HCO<sub>3</sub><sup>−</sup>
+! align="center" style="background:#4479BA; color: #FFFFFF;" + |paCO<sub>2</sub>
+! align="center" style="background:#4479BA; color: #FFFFFF;" + |O<sub>2</sub>
+! align="center" style="background:#4479BA; color: #FFFFFF;" + |Cl<sup>−</sup>
+! align="center" style="background:#4479BA; color: #FFFFFF;" + |K<sup>+</sup>
+! align="center" style="background:#4479BA; color: #FFFFFF;" + |Na<sup>+</sup>
+! align="center" style="background:#4479BA; color: #FFFFFF;" + |Ca<sup>+</sup>
+! align="center" style="background:#4479BA; color: #FFFFFF;" + |Mg<sup>+</sup>
+! align="center" style="background:#4479BA; color: #FFFFFF;" + |Renin
+! align="center" style="background:#4479BA; color: #FFFFFF;" + |Bun
+! align="center" style="background:#4479BA; color: #FFFFFF;" + |Cr
+! align="center" style="background:#4479BA; color: #FFFFFF;" + |Urine Cl<sup>−</sup>
+! align="center" style="background:#4479BA; color: #FFFFFF;" + |Gold standard diagnosis
+! align="center" style="background:#4479BA; color: #FFFFFF;" + |Other findings
+|-
+! rowspan="8" align="center" style="background:#4479BA; color: #FFFFFF;" + |Gastrointestinal origin
+! colspan="2" align="center" style="background:#DCDCDC;" + |[[Vomiting]]<ref name="GanMeyer2003">{{cite journal|last1=Gan|first1=Tong J.|last2=Meyer|first2=Tricia|last3=Apfel|first3=Christian C.|last4=Chung|first4=Frances|last5=Davis|first5=Peter J.|last6=Eubanks|first6=Steve|last7=Kovac|first7=Anthony|last8=Philip|first8=Beverly K.|last9=Sessler|first9=Daniel I.|last10=Temo|first10=James|last11=Tram??r|first11=Martin R.|last12=Watcha|first12=Mehernoor|title=Consensus Guidelines for Managing Postoperative Nausea and Vomiting|journal=Anesthesia & Analgesia|year=2003|pages=62–71|issn=0003-2999|doi=10.1213/01.ANE.0000068580.00245.95}}</ref>
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + | −
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + | −
+| align="center" style="background:#F5F5F5;" + |±
+| align="center" style="background:#F5F5F5;" + | −
+| align="center" style="background:#F5F5F5;" + | −
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + |↓
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + |↑
+| align="center" style="background:#F5F5F5;" + |↑
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + |↓
+| align="center" style="background:#F5F5F5;" + |↓
+| align="center" style="background:#F5F5F5;" + |↑
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + |↑
+| align="center" style="background:#F5F5F5;" + |Nl to ↑
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + |↓
+| align="center" style="background:#F5F5F5;" + |Clinical  manifestations
+| align="left" style="background:#F5F5F5;" + |
+* Not applicable
+|-
+! colspan="2" align="center" style="background:#DCDCDC;" + |Nasogastric tube suction<ref name="GilbertsonRogers2011">{{cite journal|last1=Gilbertson|first1=Heather Ruth|last2=Rogers|first2=Elizabeth Jessie|last3=Ukoumunne|first3=Obioha Chukwunyere|title=Determination of a Practical pH Cutoff Level for Reliable Confirmation of Nasogastric Tube Placement|journal=Journal of Parenteral and Enteral Nutrition|volume=35|issue=4|year=2011|pages=540–544|issn=0148-6071|doi=10.1177/0148607110383285}}</ref>
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + | −
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + | −
+| align="center" style="background:#F5F5F5;" + | −
+| align="center" style="background:#F5F5F5;" + | −
+| align="center" style="background:#F5F5F5;" + | −
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + |↓
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + |↑
+| align="center" style="background:#F5F5F5;" + |↑
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + |↓
+| align="center" style="background:#F5F5F5;" + |↓
+| align="center" style="background:#F5F5F5;" + |↑
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + |↑
+| align="center" style="background:#F5F5F5;" + |Nl to ↑
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + |↓
+| align="center" style="background:#F5F5F5;" + |Clinical  manifestations
+| align="left" style="background:#F5F5F5;" + |
+* [[Gastroesophageal reflux disease|GERD]]
+* [[Pulmonary aspiration]]
+|-
+! colspan="2" align="center" style="background:#DCDCDC;" + |[[Zollinger-Ellison syndrome|Zollinger−Ellison syndrome]]<ref name="HungSchubert2003">{{cite journal|last1=Hung|first1=Patrick D.|last2=Schubert|first2=Mitchell L.|last3=Mihas|first3=Anastasios A.|title=Zollinger-Ellison syndrome|journal=Current Treatment Options in Gastroenterology|volume=6|issue=2|year=2003|pages=163–170|issn=1092-8472|doi=10.1007/s11938-003-0017-6}}</ref>
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + |−
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + |−
+| align="center" style="background:#F5F5F5;" + | −
+| align="center" style="background:#F5F5F5;" + |−
+| align="center" style="background:#F5F5F5;" + |−
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + |↓
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + |↑
+| align="center" style="background:#F5F5F5;" + |↑
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + |↓
+| align="center" style="background:#F5F5F5;" + |↓
+| align="center" style="background:#F5F5F5;" + |↑
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + |↑
+| align="center" style="background:#F5F5F5;" + |Nl to ↑
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + |↓
+| align="center" style="background:#F5F5F5;" + |Serum [[gastrin]] concentration + [[secretin]] stimulation test
+| align="left" style="background:#F5F5F5;" + |
+* Multiple or refractory [[Peptic ulcer|peptic ulcers]]
+* [[Chronic diarrhea]]
+* [[MEN1]]
+|-
+! colspan="2" align="center" style="background:#DCDCDC;" + |[[Bulimia nervosa]]<ref name="ShapiroBerkman2007">{{cite journal|last1=Shapiro|first1=Jennifer R.|last2=Berkman|first2=Nancy D.|last3=Brownley|first3=Kimberly A.|last4=Sedway|first4=Jan A.|last5=Lohr|first5=Kathleen N.|last6=Bulik|first6=Cynthia M.|title=Bulimia nervosa treatment: A systematic review of randomized controlled trials|journal=International Journal of Eating Disorders|volume=40|issue=4|year=2007|pages=321–336|issn=02763478|doi=10.1002/eat.20372}}</ref>
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + |−
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + |−
+| align="center" style="background:#F5F5F5;" + | −
+| align="center" style="background:#F5F5F5;" + |−
+| align="center" style="background:#F5F5F5;" + |±
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + |↓
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + |↑
+| align="center" style="background:#F5F5F5;" + |↑
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + |↓
+| align="center" style="background:#F5F5F5;" + |↓
+| align="center" style="background:#F5F5F5;" + |↓
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + |↓
+| align="center" style="background:#F5F5F5;" + |↑
+| align="center" style="background:#F5F5F5;" + |Nl to ↑
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + |↓
+| align="center" style="background:#F5F5F5;" + |High level of suspicion
+| align="left" style="background:#F5F5F5;" + |
+* [[Lethargy]]
+* Irregular [[Menstruation|menses]]
+* [[Abdominal pain]]
+* [[Constipation]]
+* [[Salivary gland]] hypertrophy
+|-
+! colspan="2" align="center" style="background:#DCDCDC;" + |Congenital chloridorrhea<ref name="WedenojaHãGlund2010">{{cite journal|last1=Wedenoja|first1=S.|last2=HãGlund|first2=P.|last3=Holmberg|first3=C.|title=Review article: the clinical management of congenital chloride diarrhoea|journal=Alimentary Pharmacology & Therapeutics|volume=31|issue=4|year=2010|pages=477–485|issn=02692813|doi=10.1111/j.1365-2036.2009.04197.x}}</ref>
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + | −
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + | −
+| align="center" style="background:#F5F5F5;" + | −
+| align="center" style="background:#F5F5F5;" + | −
+| align="center" style="background:#F5F5F5;" + |±
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + |↓
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + |↑
+| align="center" style="background:#F5F5F5;" + |↑
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + |↓
+| align="center" style="background:#F5F5F5;" + |↓
+| align="center" style="background:#F5F5F5;" + |↓
+| align="center" style="background:#F5F5F5;" + |↓
+| align="center" style="background:#F5F5F5;" + |↓
+| align="center" style="background:#F5F5F5;" + |↑
+| align="center" style="background:#F5F5F5;" + |Nl to ↑
+| align="center" style="background:#F5F5F5;" + |Nl to ↑
+| align="center" style="background:#F5F5F5;" + |Nl to ↑
+| align="center" style="background:#F5F5F5;" + |Clinical  manifestations+ lab findings
+| align="left" style="background:#F5F5F5;" + |
+* Profuse [[diarrhea]]
+* [[Polyhydramnios]]
+|-
+! colspan="2" align="center" style="background:#DCDCDC;" + |[[Pyloric stenosis]]<ref name="BakalSarac2016">{{cite journal|last1=Bakal|first1=Unal|last2=Sarac|first2=Mehmet|last3=Aydin|first3=Mustafa|last4=Tartar|first4=Tugay|last5=Kazez|first5=Ahmet|title=Recent changes in the features of hypertrophic pyloric stenosis|journal=Pediatrics International|volume=58|issue=5|year=2016|pages=369–371|issn=13288067|doi=10.1111/ped.12860}}</ref>
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + |−
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + |−
+| align="center" style="background:#F5F5F5;" + | −
+| align="center" style="background:#F5F5F5;" + |−
+| align="center" style="background:#F5F5F5;" + |−
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + |↓
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + |↑
+| align="center" style="background:#F5F5F5;" + |↑
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + |↓
+| align="center" style="background:#F5F5F5;" + |↓
+| align="center" style="background:#F5F5F5;" + |↓ ↑
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + |↑
+| align="center" style="background:#F5F5F5;" + |Nl to ↑
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + |↓
+| align="center" style="background:#F5F5F5;" + |Physical exam + imaging
+| align="left" style="background:#F5F5F5;" + |
+* Palpation of the “olive”
+|-
+! colspan="2" align="center" style="background:#DCDCDC;" + |[[Villous adenoma]]<ref name="GennariWeise2008">{{cite journal|last1=Gennari|first1=F. J.|last2=Weise|first2=W. J.|title=Acid-Base Disturbances in Gastrointestinal Disease|journal=Clinical Journal of the American Society of Nephrology|volume=3|issue=6|year=2008|pages=1861–1868|issn=1555-9041|doi=10.2215/CJN.02450508}}</ref>
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + |−
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + | −
+| align="center" style="background:#F5F5F5;" + | −
+| align="center" style="background:#F5F5F5;" + | −
+| align="center" style="background:#F5F5F5;" + | −
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + |↓
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + |↑
+| align="center" style="background:#F5F5F5;" + |↑
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + |↓
+| align="center" style="background:#F5F5F5;" + |↓
+| align="center" style="background:#F5F5F5;" + |↓
+| align="center" style="background:#F5F5F5;" + |↓
+| align="center" style="background:#F5F5F5;" + |↓
+| align="center" style="background:#F5F5F5;" + |↑
+| align="center" style="background:#F5F5F5;" + |Nl to ↑
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + |↑
+| align="center" style="background:#F5F5F5;" + |[[Colonoscopy]]
+| align="left" style="background:#F5F5F5;" + |
+* [[Metabolic acidosis]]
+|-
+! colspan="2" align="center" style="background:#DCDCDC;" + |Gastrocystoplasty<ref name="KurzrockBaskin1998">{{cite journal|last1=Kurzrock|first1=Eric A.|last2=Baskin|first2=Laurence S.|last3=Kogan|first3=Barry A.|title=GASTROCYSTOPLASTY: LONG-TERM FOLLOWUP|journal=The Journal of Urology|volume=160|issue=6|year=1998|pages=2182–2186|issn=00225347|doi=10.1016/S0022-5347(01)62289-4}}</ref>
+| align="center" style="background:#F5F5F5;" + | −
+| align="center" style="background:#F5F5F5;" + | −
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + | −
+| align="center" style="background:#F5F5F5;" + | −
+| align="center" style="background:#F5F5F5;" + | −
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + | −
+| align="center" style="background:#F5F5F5;" + |↓
+| align="center" style="background:#F5F5F5;" + | −
+| align="center" style="background:#F5F5F5;" + |↑
+| align="center" style="background:#F5F5F5;" + |↑
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + |↓
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + |Nl to ↑
+| align="center" style="background:#F5F5F5;" + |Nl to ↑
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + |History of operation
+| align="left" style="background:#F5F5F5;" + |
+* [[Hematuria]]−[[dysuria]] syndrome
+|-
+! align="center" style="background:#4479BA; color: #FFFFFF;" + |Category
+! colspan="2" align="center" style="background:#4479BA; color: #FFFFFF;" + |Disease
+! align="center" style="background:#4479BA; color: #FFFFFF;" + |Hydrogen loss
+! align="center" style="background:#4479BA; color: #FFFFFF;" + |Accumulation of base
+! align="center" style="background:#4479BA; color: #FFFFFF;" + |Chloride depletion
+! align="center" style="background:#4479BA; color: #FFFFFF;" + |Mineralocorticoid excess
+! align="center" style="background:#4479BA; color: #FFFFFF;" + |Fever
+! align="center" style="background:#4479BA; color: #FFFFFF;" + |Dyspnea
+! align="center" style="background:#4479BA; color: #FFFFFF;" + |Edema
+! align="center" style="background:#4479BA; color: #FFFFFF;" + |Toxic/ill
+! align="center" style="background:#4479BA; color: #FFFFFF;" + |BP
+! align="center" style="background:#4479BA; color: #FFFFFF;" + |Dehydration
+! align="center" style="background:#4479BA; color: #FFFFFF;" + |HCO<sub>3</sub><sup>−</sup>
+! align="center" style="background:#4479BA; color: #FFFFFF;" + |paCO<sub>2</sub>
+! align="center" style="background:#4479BA; color: #FFFFFF;" + |O<sub>2</sub>
+! align="center" style="background:#4479BA; color: #FFFFFF;" + |Cl<sup>−</sup>
+! align="center" style="background:#4479BA; color: #FFFFFF;" + |K<sup>+</sup>
+! align="center" style="background:#4479BA; color: #FFFFFF;" + |Na<sup>+</sup>
+! align="center" style="background:#4479BA; color: #FFFFFF;" + |Ca<sup>+</sup>
+! align="center" style="background:#4479BA; color: #FFFFFF;" + |Mg<sup>+</sup>
+! align="center" style="background:#4479BA; color: #FFFFFF;" + |Renin
+! align="center" style="background:#4479BA; color: #FFFFFF;" + |Bun
+! align="center" style="background:#4479BA; color: #FFFFFF;" + |Cr
+! align="center" style="background:#4479BA; color: #FFFFFF;" + |Urine Cl<sup>−</sup>
+! align="center" style="background:#4479BA; color: #FFFFFF;" + |Gold standard diagnosis
+! align="center" style="background:#4479BA; color: #FFFFFF;" + |Other findings
+|-
+! rowspan="8" align="center" style="background:#4479BA; color: #FFFFFF;" + |Renal origin
+! colspan="2" align="center" style="background:#DCDCDC;" + |Posthypercapnic state<ref name="BangaKhilnani2009">{{cite journal|last1=Banga|first1=Amit|last2=Khilnani|first2=G. C.|title=Post-hypercapnic Alkalosis is Associated with Ventilator Dependence and Increased ICU stay|journal=COPD: Journal of Chronic Obstructive Pulmonary Disease|volume=6|issue=6|year=2009|pages=437–440|issn=1541-2555|doi=10.3109/15412550903341448}}</ref>
+| align="center" style="background:#F5F5F5;" + | −
+| align="center" style="background:#F5F5F5;" + | −
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + | −
+| align="center" style="background:#F5F5F5;" + |±
+| align="center" style="background:#F5F5F5;" + | −
+| align="center" style="background:#F5F5F5;" + | −
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + |−
+| align="center" style="background:#F5F5F5;" + |↑
+| align="center" style="background:#F5F5F5;" + |↑↑
+| align="center" style="background:#F5F5F5;" + |↓
+| align="center" style="background:#F5F5F5;" + |↓
+| align="center" style="background:#F5F5F5;" + |↓
+| align="center" style="background:#F5F5F5;" + |↑
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + |↑
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + |Lab findings
+| align="left" style="background:#F5F5F5;" + |
+* Chronic [[respiratory acidosis]]
+|-
+! colspan="2" align="center" style="background:#DCDCDC;" + |[[Hypomagnesemia]]<ref name="pmid9252977">{{cite journal |vauthors=Elisaf M, Milionis H, Siamopoulos KC |title=Hypomagnesemic hypokalemia and hypocalcemia: clinical and laboratory characteristics |journal=Miner Electrolyte Metab |volume=23 |issue=2 |pages=105–12 |date=1997 |pmid=9252977 |doi= |url=}}</ref>
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + |−
+| align="center" style="background:#F5F5F5;" + |−
+| align="center" style="background:#F5F5F5;" + |−
+| align="center" style="background:#F5F5F5;" + |−
+| align="center" style="background:#F5F5F5;" + |−
+| align="center" style="background:#F5F5F5;" + |−
+| align="center" style="background:#F5F5F5;" + |−
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + |−
+| align="center" style="background:#F5F5F5;" + |↑
+| align="center" style="background:#F5F5F5;" + |↑
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + |↓
+| align="center" style="background:#F5F5F5;" + |↓
+| align="center" style="background:#F5F5F5;" + |↑
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + |↑
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + |Lab findings
+| align="left" style="background:#F5F5F5;" + |
+* Not applicable
+|-
+! colspan="2" align="center" style="background:#DCDCDC;" + |[[Hypokalemia]]<ref name="pmid10665945">{{cite journal |vauthors=Galla JH |title=Metabolic alkalosis |journal=J. Am. Soc. Nephrol. |volume=11 |issue=2 |pages=369–75 |date=February 2000 |pmid=10665945 |doi= |url=}}</ref>
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + |−
+| align="center" style="background:#F5F5F5;" + |−
+| align="center" style="background:#F5F5F5;" + |−
+| align="center" style="background:#F5F5F5;" + |−
+| align="center" style="background:#F5F5F5;" + |−
+| align="center" style="background:#F5F5F5;" + |−
+| align="center" style="background:#F5F5F5;" + |−
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + |−
+| align="center" style="background:#F5F5F5;" + |↑
+| align="center" style="background:#F5F5F5;" + |↑
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + |↓
+| align="center" style="background:#F5F5F5;" + |↓
+| align="center" style="background:#F5F5F5;" + |↑
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + |↑
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + |Lab findings
+| align="left" style="background:#F5F5F5;" + |
+* Not applicable
+|-
+! colspan="2" align="center" style="background:#DCDCDC;" + |[[Bartter's syndrome]]<ref name="SimonKaret1996">{{cite journal|last1=Simon|first1=David B.|last2=Karet|first2=Fiona E.|last3=Hamdan|first3=Jahed M.|last4=Pietro|first4=Antonio Di|last5=Sanjad|first5=Sami A.|last6=Lifton|first6=Richard P.|title=Bartter's syndrome, hypokalaemic alkalosis with hypercalciuria, is caused by mutations in the Na–K–2CI cotransporter NKCC2|journal=Nature Genetics|volume=13|issue=2|year=1996|pages=183–188|issn=1061-4036|doi=10.1038/ng0696-183}}</ref>
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + | −
+| align="center" style="background:#F5F5F5;" + | −
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + | −
+| align="center" style="background:#F5F5F5;" + | −
+| align="center" style="background:#F5F5F5;" + | −
+| align="center" style="background:#F5F5F5;" + | −
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + |↑
+| align="center" style="background:#F5F5F5;" + |↑
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + |↓
+| align="center" style="background:#F5F5F5;" + |↓↓
+| align="center" style="background:#F5F5F5;" + |↓
+| align="center" style="background:#F5F5F5;" + |↓
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + |↑
+| align="center" style="background:#F5F5F5;" + |Nl to ↑
+| align="center" style="background:#F5F5F5;" + |Nl to ↑
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + |Genetic testing
+| align="left" style="background:#F5F5F5;" + |
+* [[Constipation]]
+* [[Cramp|Muscle cramps]] and [[Muscle weakness|weakness]]
+* [[Failure to thrive]]
+* [[Sensorineural hearing loss|Sensorineural deafness]]
+* [[Focal segmental glomerulosclerosis]]
+* [[Hypercalciuria]]
+|-
+! colspan="2" align="center" style="background:#DCDCDC;" + |[[Gitelman syndrome|Gitelman’s syndrome]]<ref name="FremontChan2012">{{cite journal|last1=Fremont|first1=Oliver T.|last2=Chan|first2=James C. M.|title=Understanding Bartter syndrome and Gitelman syndrome|journal=World Journal of Pediatrics|volume=8|issue=1|year=2012|pages=25–30|issn=1708-8569|doi=10.1007/s12519-012-0333-9}}</ref><ref name="pmid7700218">{{cite journal |vauthors=Colussi G, Macaluso M, Brunati C, Minetti L |title=Calcium metabolism and calciotropic hormone levels in Gitelman's syndrome |journal=Miner Electrolyte Metab |volume=20 |issue=5 |pages=294–301 |date=1994 |pmid=7700218 |doi= |url=}}</ref>
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + | −
+| align="center" style="background:#F5F5F5;" + | −
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + | −
+| align="center" style="background:#F5F5F5;" + | −
+| align="center" style="background:#F5F5F5;" + | −
+| align="center" style="background:#F5F5F5;" + | −
+| align="center" style="background:#F5F5F5;" + |↓
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + |↑
+| align="center" style="background:#F5F5F5;" + |↑
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + |↓
+| align="center" style="background:#F5F5F5;" + |↓↓
+| align="center" style="background:#F5F5F5;" + |↓
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + |↓
+| align="center" style="background:#F5F5F5;" + |↑
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + |Genetic testing
+| align="left" style="background:#F5F5F5;" + |
+* Less severe
+* [[Constipation]]
+* [[Cramp|Muscle cramps]] and [[Muscle weakness|weakness]]
+* [[Hypocalciuria]]
+|-
+! colspan="2" align="center" style="background:#DCDCDC;" + |[[Renal artery stenosis]]<ref name="SafianTextor2001">{{cite journal|last1=Safian|first1=Robert D.|last2=Textor|first2=Stephen C.|title=Renal-Artery Stenosis|journal=New England Journal of Medicine|volume=344|issue=6|year=2001|pages=431–442|issn=0028-4793|doi=10.1056/NEJM200102083440607}}</ref>
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + | −
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + | −
+| align="center" style="background:#F5F5F5;" + | −
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + |↑
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + |↑
+| align="center" style="background:#F5F5F5;" + |↑
+| align="center" style="background:#F5F5F5;" + |↓
+| align="center" style="background:#F5F5F5;" + |↓
+| align="center" style="background:#F5F5F5;" + |↑
+| align="center" style="background:#F5F5F5;" + |↓
+| align="center" style="background:#F5F5F5;" + |↑
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + |↑
+| align="center" style="background:#F5F5F5;" + |↑
+| align="center" style="background:#F5F5F5;" + |↑
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + |Clinical  manifestations+ imaging
+| align="left" style="background:#F5F5F5;" + |
+* [[Chronic renal failure|Chronic kidney disease]]
+* Acute rise in [[Creatinine|Cr]] following [[ACE inhibitor|ACEIs]] or [[Angiotensin II receptor antagonist|ARBs]]
+|-
+! colspan="2" align="center" style="background:#DCDCDC;" + |[[Liddle's syndrome|Liddle syndrome]]<ref name="SalihGautschi2017">{{cite journal|last1=Salih|first1=Mahdi|last2=Gautschi|first2=Ivan|last3=van Bemmelen|first3=Miguel X.|last4=Di Benedetto|first4=Michael|last5=Brooks|first5=Alice S.|last6=Lugtenberg|first6=Dorien|last7=Schild|first7=Laurent|last8=Hoorn|first8=Ewout J.|title=A Missense Mutation in the Extracellular Domain ofαENaC Causes Liddle Syndrome|journal=Journal of the American Society of Nephrology|volume=28|issue=11|year=2017|pages=3291–3299|issn=1046-6673|doi=10.1681/ASN.2016111163}}</ref>
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + | −
+| align="center" style="background:#F5F5F5;" + | −
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + | −
+| align="center" style="background:#F5F5F5;" + | −
+| align="center" style="background:#F5F5F5;" + | −
+| align="center" style="background:#F5F5F5;" + | −
+| align="center" style="background:#F5F5F5;" + |↑
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + |↑
+| align="center" style="background:#F5F5F5;" + |↑
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + |↓
+| align="center" style="background:#F5F5F5;" + |↓↓
+| align="center" style="background:#F5F5F5;" + |↓
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + |↓
+| align="center" style="background:#F5F5F5;" + |↑
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + |Genetic testing
+| align="left" style="background:#F5F5F5;" + |
+* Not applicable
 |-
-| colspan="3" rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;|'''Symptoms'''
+! colspan="2" align="center" style="background:#DCDCDC;" + |[[Renal cell carcinoma|Renal tumors]]<ref name="LasseigneBrooks2018">{{cite journal|last1=Lasseigne|first1=Brittany N.|last2=Brooks|first2=James D.|title=The Role of DNA Methylation in Renal Cell Carcinoma|journal=Molecular Diagnosis & Therapy|year=2018|issn=1177-1062|doi=10.1007/s40291-018-0337-9}}</ref>
-! colspan="3" rowspan="2"  style="background: #4479BA; color: #FFFFFF; text-align: center;|Physical examination
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + | −
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + | −
+| align="center" style="background:#F5F5F5;" + | −
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + |↑
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + |↑
+| align="center" style="background:#F5F5F5;" + |↑
+| align="center" style="background:#F5F5F5;" + |↓
+| align="center" style="background:#F5F5F5;" + |↓
+| align="center" style="background:#F5F5F5;" + |↑
+| align="center" style="background:#F5F5F5;" + |↓
+| align="center" style="background:#F5F5F5;" + |↑
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + |↑
+| align="center" style="background:#F5F5F5;" + |↑
+| align="center" style="background:#F5F5F5;" + |↑
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + |[[Biopsy]]
+| align="left" style="background:#F5F5F5;" + |
+* Not applicable
 |-
-! colspan="3" style="background: #4479BA; color: #FFFFFF; text-align: center;|Lab Findings
+! rowspan="5" align="center" style="background:#4479BA; color: #FFFFFF;" + |Endocrine
-! colspan="3" style="background: #4479BA; color: #FFFFFF; text-align: center;|Imaging
+! colspan="2" align="center" style="background:#DCDCDC;" + |[[Cushing's syndrome]]<ref name="Araujo CastroMarazuela Azpiroz2018">{{cite journal|last1=Araujo Castro|first1=Marta|last2=Marazuela Azpiroz|first2=Mónica|title=Two types of ectopic Cushing syndrome or a continuum? Review|journal=Pituitary|year=2018|issn=1386-341X|doi=10.1007/s11102-018-0894-2}}</ref>
-! rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;|Histopathology
+| align="center" style="background:#F5F5F5;" + | +
-|-
+| align="center" style="background:#F5F5F5;" + | −
-! style="background: #4479BA; color: #FFFFFF; text-align: center;|Symptom 1
+| align="center" style="background:#F5F5F5;" + | +
-! colspan="1" rowspan="1" style="background: #4479BA; color: #FFFFFF; text-align: center;|Symptom 2
+| align="center" style="background:#F5F5F5;" + | −
-! style="background: #4479BA; color: #FFFFFF; text-align: center;|Symptom 3
+| align="center" style="background:#F5F5F5;" + | −
-! style="background: #4479BA; color: #FFFFFF; text-align: center;|Physical exam 1
+| align="center" style="background:#F5F5F5;" + | −
-! colspan="1" rowspan="1" style="background: #4479BA; color: #FFFFFF; text-align: center;|Physical exam 2
+| align="center" style="background:#F5F5F5;" + | +
-! style="background: #4479BA; color: #FFFFFF; text-align: center;|Physical exam 3
+| align="center" style="background:#F5F5F5;" + | −
-! style="background: #4479BA; color: #FFFFFF; text-align: center;|Lab 1
+| align="center" style="background:#F5F5F5;" + |↑
-! style="background: #4479BA; color: #FFFFFF; text-align: center;|Lab 2
+| align="center" style="background:#F5F5F5;" + | +
-! style="background: #4479BA; color: #FFFFFF; text-align: center;|Lab 3
+| align="center" style="background:#F5F5F5;" + |↑
-! style="background: #4479BA; color: #FFFFFF; text-align: center;|Imaging 1
+| align="center" style="background:#F5F5F5;" + |↑
-! style="background: #4479BA; color: #FFFFFF; text-align: center;|Imaging 2
+| align="center" style="background:#F5F5F5;" + |Nl
-! style="background: #4479BA; color: #FFFFFF; text-align: center;|Imaging 3
+| align="center" style="background:#F5F5F5;" + |↓
+| align="center" style="background:#F5F5F5;" + |↑
+| align="center" style="background:#F5F5F5;" + |↓
+| align="center" style="background:#F5F5F5;" + |↑
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + |↓
+| align="center" style="background:#F5F5F5;" + |↑
+| align="center" style="background:#F5F5F5;" + |↑
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + |24−hour urinary [[cortisol]] excretion + low−dose [[dexamethasone suppression test]]
+| align="left" style="background:#F5F5F5;" + |
+* [[Obesity]]
+* [[Lethargy]]
+* [[Hirsutism]]
+* [[Menstrual cycle|Menstrual]] changes
 |-
-| style="background: #DCDCDC; padding: 5px; text-align: center;" |Differential Diagnosis 1
+! rowspan="2" align="center" style="background:#DCDCDC;" + |[[Hyperaldosteronism]]
-| style="background: #F5F5F5; padding: 5px;" |
+! align="center" style="background:#DCDCDC;" + |[[Primary hyperaldosteronism|Primary]]<ref name="Martell-ClarosAbad-Cardiel2015">{{cite journal|last1=Martell-Claros|first1=Nieves|last2=Abad-Cardiel|first2=María|last3=Alvarez-Alvarez|first3=Beatriz|last4=García-Donaire|first4=José A.|last5=Pérez|first5=Cristina Fernández|title=Primary aldosteronism and its various clinical scenarios|journal=Journal of Hypertension|volume=33|issue=6|year=2015|pages=1226–1232|issn=0263-6352|doi=10.1097/HJH.0000000000000546}}</ref>
-| style="background: #F5F5F5; padding: 5px;" |
+| align="center" style="background:#F5F5F5;" + | +
-| style="background: #F5F5F5; padding: 5px;" |
+| align="center" style="background:#F5F5F5;" + | −
-| style="background: #F5F5F5; padding: 5px;" |
+| align="center" style="background:#F5F5F5;" + | +
-| style="background: #F5F5F5; padding: 5px;" |
+| align="center" style="background:#F5F5F5;" + | −
-| style="background: #F5F5F5; padding: 5px;" |
+| align="center" style="background:#F5F5F5;" + | −
-| style="background: #F5F5F5; padding: 5px;" |
+| align="center" style="background:#F5F5F5;" + | −
-| style="background: #F5F5F5; padding: 5px;" |
+| align="center" style="background:#F5F5F5;" + | +
-| style="background: #F5F5F5; padding: 5px;" |
+| align="center" style="background:#F5F5F5;" + | −
-| style="background: #F5F5F5; padding: 5px;" |
+| align="center" style="background:#F5F5F5;" + |↑
-| style="background: #F5F5F5; padding: 5px;" |
+| align="center" style="background:#F5F5F5;" + | +
-| style="background: #F5F5F5; padding: 5px;" |
+| align="center" style="background:#F5F5F5;" + |↑
-| style="background: #F5F5F5; padding: 5px;" |
+| align="center" style="background:#F5F5F5;" + |↑
-| style="background: #F5F5F5; padding: 5px;" |
+| align="center" style="background:#F5F5F5;" + |Nl
-| style="background: #F5F5F5; padding: 5px;" |
+| align="center" style="background:#F5F5F5;" + |↓
+| align="center" style="background:#F5F5F5;" + |Nl to ↓
+| align="center" style="background:#F5F5F5;" + |↓
+| align="center" style="background:#F5F5F5;" + |↑
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + |↓
+| align="center" style="background:#F5F5F5;" + |↑
+| align="center" style="background:#F5F5F5;" + |↑
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + |Lab findings
+| align="left" style="background:#F5F5F5;" + |
+* Resistant [[Hypertension|HTN]]
+* Aldosterone−producing adenomas
+* Bilateral [[adrenal hyperplasia]]
 |-
-| style="background: #DCDCDC; padding: 5px; text-align: center;" |Differential Diagnosis 2
+! align="center" style="background:#DCDCDC;" + |[[Secondary hyperaldosteronism|Secondary]]<ref name="pmid29758100">{{cite journal |vauthors=Monticone S, Losano I, Tetti M, Buffolo F, Veglio F, Mulatero P |title=Diagnostic approach to low renin hypertension |journal=Clin. Endocrinol. (Oxf) |volume= |issue= |pages= |date=May 2018 |pmid=29758100 |doi=10.1111/cen.13741 |url=}}</ref>
-| style="background: #F5F5F5; padding: 5px;" |
+| align="center" style="background:#F5F5F5;" + | +
-| style="background: #F5F5F5; padding: 5px;" |
+| align="center" style="background:#F5F5F5;" + | −
-| style="background: #F5F5F5; padding: 5px;" |
+| align="center" style="background:#F5F5F5;" + | +
-| style="background: #F5F5F5; padding: 5px;" |
+| align="center" style="background:#F5F5F5;" + | −
-| style="background: #F5F5F5; padding: 5px;" |
+| align="center" style="background:#F5F5F5;" + | −
-| style="background: #F5F5F5; padding: 5px;" |
+| align="center" style="background:#F5F5F5;" + | +
-| style="background: #F5F5F5; padding: 5px;" |
+| align="center" style="background:#F5F5F5;" + | +
-| style="background: #F5F5F5; padding: 5px;" |
+| align="center" style="background:#F5F5F5;" + | +
-| style="background: #F5F5F5; padding: 5px;" |
+| align="center" style="background:#F5F5F5;" + |↑
-| style="background: #F5F5F5; padding: 5px;" |
+| align="center" style="background:#F5F5F5;" + | +
-| style="background: #F5F5F5; padding: 5px;" |
+| align="center" style="background:#F5F5F5;" + |↑
-| style="background: #F5F5F5; padding: 5px;" |
+| align="center" style="background:#F5F5F5;" + |↑
-| style="background: #F5F5F5; padding: 5px;" |
+| align="center" style="background:#F5F5F5;" + |Nl
-| style="background: #F5F5F5; padding: 5px;" |
+| align="center" style="background:#F5F5F5;" + |↓
-| style="background: #F5F5F5; padding: 5px;" |
+| align="center" style="background:#F5F5F5;" + |↓
+| align="center" style="background:#F5F5F5;" + |↑
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + |↓
+| align="center" style="background:#F5F5F5;" + |↑
+| align="center" style="background:#F5F5F5;" + |↑
+| align="center" style="background:#F5F5F5;" + |↑
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + |Lab findings
+| align="left" style="background:#F5F5F5;" + |
+* [[Renin-producing tumors|Renin−producing tumor]]
+* [[Renal artery stenosis]]
+* Left ventricular [[Congestive heart failure|heart failure]]
+* [[Right heart failure|Cor pulmonale]]
+* [[Cirrhosis]] with [[ascites]]
 |-
-| style="background: #DCDCDC; padding: 5px; text-align: center;" |Differential Diagnosis 3
+! rowspan="2" align="center" style="background:#DCDCDC;" + |[[Congenital adrenal hyperplasia]]
-| style="background: #F5F5F5; padding: 5px;" |
+! align="center" style="background:#DCDCDC;" + |[[11β-hydroxylase deficiency|11β−Hydroxylase deficiency]]<ref name="pmid29626607">{{cite journal |vauthors=Baş F, Toksoy G, Ergun-Longmire B, Uyguner ZO, Abalı ZY, Poyrazoğlu Ş, Karaman V, Avcı Ş, Altunoğlu U, Bundak R, Karaman B, Başaran S, Darendeliler F |title=Prevalence, clinical characteristics and long-term outcomes of classical 11 β-hydroxylase deficiency (11BOHD) in Turkish population and novel mutations in CYP11B1 gene |journal=J. Steroid Biochem. Mol. Biol. |volume= |issue= |pages= |date=April 2018 |pmid=29626607 |doi=10.1016/j.jsbmb.2018.04.001 |url=}}</ref>
-| style="background: #F5F5F5; padding: 5px;" |
+| align="center" style="background:#F5F5F5;" + |−
-| style="background: #F5F5F5; padding: 5px;" |
+| align="center" style="background:#F5F5F5;" + | −
-| style="background: #F5F5F5; padding: 5px;" |
+| align="center" style="background:#F5F5F5;" + |−
-| style="background: #F5F5F5; padding: 5px;" |
+| align="center" style="background:#F5F5F5;" + | +
-| style="background: #F5F5F5; padding: 5px;" |
+| align="center" style="background:#F5F5F5;" + | −
-| style="background: #F5F5F5; padding: 5px;" |
+| align="center" style="background:#F5F5F5;" + | −
-| style="background: #F5F5F5; padding: 5px;" |
+| align="center" style="background:#F5F5F5;" + | +
-| style="background: #F5F5F5; padding: 5px;" |
+| align="center" style="background:#F5F5F5;" + | −
-| style="background: #F5F5F5; padding: 5px;" |
+| align="center" style="background:#F5F5F5;" + |↑
-| style="background: #F5F5F5; padding: 5px;" |
+| align="center" style="background:#F5F5F5;" + | +
-| style="background: #F5F5F5; padding: 5px;" |
+| align="center" style="background:#F5F5F5;" + |↑
-| style="background: #F5F5F5; padding: 5px;" |
+| align="center" style="background:#F5F5F5;" + |↑
-| style="background: #F5F5F5; padding: 5px;" |
+| align="center" style="background:#F5F5F5;" + |Nl
-| style="background: #F5F5F5; padding: 5px;" |
+| align="center" style="background:#F5F5F5;" + |↓
-|- style="background: #4479BA; color: #FFFFFF; text-align: center;"
+| align="center" style="background:#F5F5F5;" + |↓
-!Diseases
+| align="center" style="background:#F5F5F5;" + |↓
-!Symptom 1
+| align="center" style="background:#F5F5F5;" + |↑
-! colspan="1" rowspan="1" |Symptom 2
+| align="center" style="background:#F5F5F5;" + |Nl
-!Symptom 3
+| align="center" style="background:#F5F5F5;" + |↓
-!Physical exam 1
+| align="center" style="background:#F5F5F5;" + |Nl
-! colspan="1" rowspan="1" |Physical exam 2
+| align="center" style="background:#F5F5F5;" + |Nl
-!Physical exam 3
+| align="center" style="background:#F5F5F5;" + |Nl
-!Lab 1
+| align="center" style="background:#F5F5F5;" + |Genetic testing
-!Lab 2
+| align="left" style="background:#F5F5F5;" + |
-!Lab 3
+* [[Virilization]]
-!Imaging 1
+* [[Hyperpigmentation|Skin hyperpigmentation]]
-!Imaging 2
+* Bilateral [[adrenal gland]] enlargement
-!Imaging 3
-!Histopathology
-|'''Gold standard'''
-!Additional findings
 |-
-| style="background: #DCDCDC; padding: 5px; text-align: center;" |Differential Diagnosis 4
+! align="center" style="background:#DCDCDC;" + |[[17 alpha-hydroxylase deficiency|17α−Hydroxylase deficiency]]<ref name="GoldsmithSolomon1967">{{cite journal|last1=Goldsmith|first1=Oliver|last2=Solomon|first2=David H.|last3=Horton|first3=Richard|title=Hypogonadism and Mineralocorticoid Excess|journal=New England Journal of Medicine|volume=277|issue=13|year=1967|pages=673–677|issn=0028-4793|doi=10.1056/NEJM196709282771302}}</ref>
-| style="background: #F5F5F5; padding: 5px;" |
+| align="center" style="background:#F5F5F5;" + |−
-| style="background: #F5F5F5; padding: 5px;" |
+| align="center" style="background:#F5F5F5;" + | −
-| style="background: #F5F5F5; padding: 5px;" |
+| align="center" style="background:#F5F5F5;" + |−
-| style="background: #F5F5F5; padding: 5px;" |
+| align="center" style="background:#F5F5F5;" + | +
-| style="background: #F5F5F5; padding: 5px;" |
+| align="center" style="background:#F5F5F5;" + | −
-| style="background: #F5F5F5; padding: 5px;" |
+| align="center" style="background:#F5F5F5;" + | −
-| style="background: #F5F5F5; padding: 5px;" |
+| align="center" style="background:#F5F5F5;" + | +
-| style="background: #F5F5F5; padding: 5px;" |
+| align="center" style="background:#F5F5F5;" + | −
-| style="background: #F5F5F5; padding: 5px;" |
+| align="center" style="background:#F5F5F5;" + |↑
-| style="background: #F5F5F5; padding: 5px;" |
+| align="center" style="background:#F5F5F5;" + | +
-| style="background: #F5F5F5; padding: 5px;" |
+| align="center" style="background:#F5F5F5;" + |↑
-| style="background: #F5F5F5; padding: 5px;" |
+| align="center" style="background:#F5F5F5;" + |↑
-| style="background: #F5F5F5; padding: 5px;" |
+| align="center" style="background:#F5F5F5;" + |Nl
-| style="background: #F5F5F5; padding: 5px;" |
+| align="center" style="background:#F5F5F5;" + |↓
-| style="background: #F5F5F5; padding: 5px;" |
+| align="center" style="background:#F5F5F5;" + |↓
+| align="center" style="background:#F5F5F5;" + |↓
+| align="center" style="background:#F5F5F5;" + |↑
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + |↓
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + |Genetic testing
+| align="left" style="background:#F5F5F5;" + |
+* [[Intersexuality|Ambiguous genitalia]]
+* [[Undescended testes]]
+* Lacks [[Secondary sexual characteristic|2° sexual development]]
+* [[Hyperpigmentation|Skin hyperpigmentation]]
+* Bilateral [[adrenal gland]] enlargement
 |-
-| style="background: #DCDCDC; padding: 5px; text-align: center;" |Differential Diagnosis 5
+! align="center" style="background:#4479BA; color: #FFFFFF;" + |Systemic
-| style="background: #F5F5F5; padding: 5px;" |
+! colspan="2" align="center" style="background:#DCDCDC;" + |[[Cystic fibrosis]]<ref name="pmid9048354">{{cite journal |vauthors=Bates CM, Baum M, Quigley R |title=Cystic fibrosis presenting with hypokalemia and metabolic alkalosis in a previously healthy adolescent |journal=J. Am. Soc. Nephrol. |volume=8 |issue=2 |pages=352–5 |date=February 1997 |pmid=9048354 |doi= |url=}}</ref>
-| style="background: #F5F5F5; padding: 5px;" |
+| align="center" style="background:#F5F5F5;" + | +
-| style="background: #F5F5F5; padding: 5px;" |
+| align="center" style="background:#F5F5F5;" + |−
-| style="background: #F5F5F5; padding: 5px;" |
+| align="center" style="background:#F5F5F5;" + | +
-| style="background: #F5F5F5; padding: 5px;" |
+| align="center" style="background:#F5F5F5;" + |−
-| style="background: #F5F5F5; padding: 5px;" |
+| align="center" style="background:#F5F5F5;" + |−
-| style="background: #F5F5F5; padding: 5px;" |
+| align="center" style="background:#F5F5F5;" + | +
-| style="background: #F5F5F5; padding: 5px;" |
+| align="center" style="background:#F5F5F5;" + |−
-| style="background: #F5F5F5; padding: 5px;" |
+| align="center" style="background:#F5F5F5;" + | +
-| style="background: #F5F5F5; padding: 5px;" |
+| align="center" style="background:#F5F5F5;" + |↓
-| style="background: #F5F5F5; padding: 5px;" |
+| align="center" style="background:#F5F5F5;" + | +
-| style="background: #F5F5F5; padding: 5px;" |
+| align="center" style="background:#F5F5F5;" + |↑
-| style="background: #F5F5F5; padding: 5px;" |
+| align="center" style="background:#F5F5F5;" + |↑
-| style="background: #F5F5F5; padding: 5px;" |
+| align="center" style="background:#F5F5F5;" + |Nl
-| style="background: #F5F5F5; padding: 5px;" |
+| align="center" style="background:#F5F5F5;" + |↓
+| align="center" style="background:#F5F5F5;" + |↓
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + |↑
+| align="center" style="background:#F5F5F5;" + |Nl to ↑
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + |↑
+| align="center" style="background:#F5F5F5;" + |Genetic testing
+| align="left" style="background:#F5F5F5;" + |
+* [[Fatigue]]
+* Persistent pulmonary [[infection]]
+* [[Pancreatic insufficiency]]
 |-
-| style="background: #DCDCDC; padding: 5px; text-align: center;" |Differential Diagnosis 6
+! align="center" style="background:#4479BA; color: #FFFFFF;" + |Category
-| style="background: #F5F5F5; padding: 5px;" |
+! colspan="2" align="center" style="background:#4479BA; color: #FFFFFF;" + |Disease
-| style="background: #F5F5F5; padding: 5px;" |
+! align="center" style="background:#4479BA; color: #FFFFFF;" + |Hydrogen loss
-| style="background: #F5F5F5; padding: 5px;" |
+! align="center" style="background:#4479BA; color: #FFFFFF;" + |Accumulation of base
-| style="background: #F5F5F5; padding: 5px;" |
+! align="center" style="background:#4479BA; color: #FFFFFF;" + |Chloride depletion
-| style="background: #F5F5F5; padding: 5px;" |
+! align="center" style="background:#4479BA; color: #FFFFFF;" + |Mineralocorticoid excess
-| style="background: #F5F5F5; padding: 5px;" |
+! align="center" style="background:#4479BA; color: #FFFFFF;" + |Fever
-| style="background: #F5F5F5; padding: 5px;" |
+! align="center" style="background:#4479BA; color: #FFFFFF;" + |Dyspnea
-| style="background: #F5F5F5; padding: 5px;" |
+! align="center" style="background:#4479BA; color: #FFFFFF;" + |Edema
-| style="background: #F5F5F5; padding: 5px;" |
+! align="center" style="background:#4479BA; color: #FFFFFF;" + |Toxic/ill
-| style="background: #F5F5F5; padding: 5px;" |
+! align="center" style="background:#4479BA; color: #FFFFFF;" + |BP
-| style="background: #F5F5F5; padding: 5px;" |
+! align="center" style="background:#4479BA; color: #FFFFFF;" + |Dehydration
-| style="background: #F5F5F5; padding: 5px;" |
+! align="center" style="background:#4479BA; color: #FFFFFF;" + |HCO<sub>3</sub><sup>−</sup>
-| style="background: #F5F5F5; padding: 5px;" |
+! align="center" style="background:#4479BA; color: #FFFFFF;" + |paCO<sub>2</sub>
-| style="background: #F5F5F5; padding: 5px;" |
+! align="center" style="background:#4479BA; color: #FFFFFF;" + |O<sub>2</sub>
-| style="background: #F5F5F5; padding: 5px;" |
+! align="center" style="background:#4479BA; color: #FFFFFF;" + |Cl<sup>−</sup>
+! align="center" style="background:#4479BA; color: #FFFFFF;" + |K<sup>+</sup>
+! align="center" style="background:#4479BA; color: #FFFFFF;" + |Na<sup>+</sup>
+! align="center" style="background:#4479BA; color: #FFFFFF;" + |Ca<sup>+</sup>
+! align="center" style="background:#4479BA; color: #FFFFFF;" + |Mg<sup>+</sup>
+! align="center" style="background:#4479BA; color: #FFFFFF;" + |Renin
+! align="center" style="background:#4479BA; color: #FFFFFF;" + |Bun
+! align="center" style="background:#4479BA; color: #FFFFFF;" + |Cr
+! align="center" style="background:#4479BA; color: #FFFFFF;" + |Urine Cl<sup>−</sup>
+! align="center" style="background:#4479BA; color: #FFFFFF;" + |Gold standard diagnosis
+! align="center" style="background:#4479BA; color: #FFFFFF;" + |Other findings
 |}
 ==References==
-{{Reflist|2}}
+{{reflist|2}}
-{{WH}}
+[[Category:Medicine]]
-{{WS}}
+[[Category:Nephrology]]
-[[Category: (name of the system)]]
+[[Category:Up-To-Date]]

Metabolic alkalosis differential diagnosis: Difference between revisions

Latest revision as of 22:43, 29 July 2020

Overview

Metabolic Alkalosis

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