Metabolic acidosis differential diagnosis: Difference between revisions
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! rowspan="10" align="center" style="background:#4479BA; color: #FFFFFF;" + |Toxin/Medication<ref name="PhamXu2015">{{cite journal|last1=Pham|first1=Amy Quynh Trang|last2=Xu|first2=Li Hao Richie|last3=Moe|first3=Orson W.|title=Drug-Induced Metabolic Acidosis|journal=F1000Research|year=2015|issn=2046-1402|doi=10.12688/f1000research.7006.1}}</ref> | ! rowspan="10" align="center" style="background:#4479BA; color: #FFFFFF;" + |Toxin/Medication<ref name="PhamXu2015">{{cite journal|last1=Pham|first1=Amy Quynh Trang|last2=Xu|first2=Li Hao Richie|last3=Moe|first3=Orson W.|title=Drug-Induced Metabolic Acidosis|journal=F1000Research|year=2015|issn=2046-1402|doi=10.12688/f1000research.7006.1}}</ref> | ||
! rowspan="2" align="center" style="background:#DCDCDC;" + |Alcohol<ref name="pmid15902789">{{cite journal |vauthors=Zehtabchi S, Sinert R, Baron BJ, Paladino L, Yadav K |title=Does ethanol explain the acidosis commonly seen in ethanol-intoxicated patients? |journal=Clin Toxicol (Phila) |volume=43 |issue=3 |pages=161–6 |date=2005 |pmid=15902789 |doi= |url=}}</ref><ref name="RobertsYates2015">{{cite journal|last1=Roberts|first1=Darren M.|last2=Yates|first2=Christopher|last3=Megarbane|first3=Bruno|last4=Winchester|first4=James F.|last5=Maclaren|first5=Robert|last6=Gosselin|first6=Sophie|last7=Nolin|first7=Thomas D.|last8=Lavergne|first8=Valéry|last9=Hoffman|first9=Robert S.|last10=Ghannoum|first10=Marc|title=Recommendations for the Role of Extracorporeal Treatments in the Management of Acute Methanol Poisoning|journal=Critical Care Medicine|volume=43|issue=2|year=2015|pages=461–472|issn=0090-3493|doi=10.1097/CCM.0000000000000708}}</ref> | ! rowspan="2" align="center" style="background:#DCDCDC;" + |[[Alcohol]]<ref name="pmid15902789">{{cite journal |vauthors=Zehtabchi S, Sinert R, Baron BJ, Paladino L, Yadav K |title=Does ethanol explain the acidosis commonly seen in ethanol-intoxicated patients? |journal=Clin Toxicol (Phila) |volume=43 |issue=3 |pages=161–6 |date=2005 |pmid=15902789 |doi= |url=}}</ref><ref name="RobertsYates2015">{{cite journal|last1=Roberts|first1=Darren M.|last2=Yates|first2=Christopher|last3=Megarbane|first3=Bruno|last4=Winchester|first4=James F.|last5=Maclaren|first5=Robert|last6=Gosselin|first6=Sophie|last7=Nolin|first7=Thomas D.|last8=Lavergne|first8=Valéry|last9=Hoffman|first9=Robert S.|last10=Ghannoum|first10=Marc|title=Recommendations for the Role of Extracorporeal Treatments in the Management of Acute Methanol Poisoning|journal=Critical Care Medicine|volume=43|issue=2|year=2015|pages=461–472|issn=0090-3493|doi=10.1097/CCM.0000000000000708}}</ref> | ||
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* Methanol | * [[Methanol]] | ||
* Ethylene glycol | * [[Ethylene glycol]] | ||
* Propylene glycol | * [[Propylene glycol]] | ||
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* Isopropyl alcohol<ref>Ashurst JV, Nappe TM. Toxicity, Isopropanol. [Updated 2018 Mar 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2018 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK493181/</ref> | * [[Isopropyl alcohol]]<ref>Ashurst JV, Nappe TM. Toxicity, Isopropanol. [Updated 2018 Mar 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2018 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK493181/</ref> | ||
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! colspan="2" align="center" style="background:#DCDCDC;" + |Toluene<ref name="Camara-LemarroyRodríguez-Gutiérrez2015">{{cite journal|last1=Camara-Lemarroy|first1=Carlos Rodrigo|last2=Rodríguez-Gutiérrez|first2=René|last3=Monreal-Robles|first3=Roberto|last4=González-González|first4=José Gerardo|title=Acute toluene intoxication–clinical presentation, management and prognosis: a prospective observational study|journal=BMC Emergency Medicine|volume=15|issue=1|year=2015|issn=1471-227X|doi=10.1186/s12873-015-0039-0}}</ref> | ! colspan="2" align="center" style="background:#DCDCDC;" + |[[Toluene]]<ref name="Camara-LemarroyRodríguez-Gutiérrez2015">{{cite journal|last1=Camara-Lemarroy|first1=Carlos Rodrigo|last2=Rodríguez-Gutiérrez|first2=René|last3=Monreal-Robles|first3=Roberto|last4=González-González|first4=José Gerardo|title=Acute toluene intoxication–clinical presentation, management and prognosis: a prospective observational study|journal=BMC Emergency Medicine|volume=15|issue=1|year=2015|issn=1471-227X|doi=10.1186/s12873-015-0039-0}}</ref> | ||
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* Most widely abused inhaled drugs | * Most widely abused inhaled drugs | ||
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! colspan="2" align="center" style="background:#DCDCDC;" + |Salicylates<ref name="WrightSop2015">{{cite journal|last1=Wright|first1=Dallas|last2=Sop|first2=Jessica|title=Normal anion gap salicylate poisoning|journal=The American Journal of Emergency Medicine|volume=33|issue=11|year=2015|pages=1714.e3–1714.e4|issn=07356757|doi=10.1016/j.ajem.2015.03.042}}</ref> | ! colspan="2" align="center" style="background:#DCDCDC;" + |[[Salicylates]]<ref name="WrightSop2015">{{cite journal|last1=Wright|first1=Dallas|last2=Sop|first2=Jessica|title=Normal anion gap salicylate poisoning|journal=The American Journal of Emergency Medicine|volume=33|issue=11|year=2015|pages=1714.e3–1714.e4|issn=07356757|doi=10.1016/j.ajem.2015.03.042}}</ref> | ||
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* Paradoxical [[alkalosis]] | * Paradoxical [[alkalosis]] | ||
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! colspan="2" align="center" style="background:#DCDCDC;" + |Metformin<ref name="GalieroConsani2018">{{cite journal|last1=Galiero|first1=Francesca|last2=Consani|first2=Giovanni|last3=Biancofiore|first3=Gianni|last4=Ruschi|first4=Stefano|last5=Forfori|first5=Francesco|title=Metformin intoxication: Vasopressin's key role in the management of severe lactic acidosis|journal=The American Journal of Emergency Medicine|volume=36|issue=2|year=2018|pages=341.e5–341.e6|issn=07356757|doi=10.1016/j.ajem.2017.10.057}}</ref> | ! colspan="2" align="center" style="background:#DCDCDC;" + |[[Metformin]]<ref name="GalieroConsani2018">{{cite journal|last1=Galiero|first1=Francesca|last2=Consani|first2=Giovanni|last3=Biancofiore|first3=Gianni|last4=Ruschi|first4=Stefano|last5=Forfori|first5=Francesco|title=Metformin intoxication: Vasopressin's key role in the management of severe lactic acidosis|journal=The American Journal of Emergency Medicine|volume=36|issue=2|year=2018|pages=341.e5–341.e6|issn=07356757|doi=10.1016/j.ajem.2017.10.057}}</ref> | ||
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* [[Hepatic failure|Liver failure]] | * [[Hepatic failure|Liver failure]] | ||
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! colspan="2" align="center" style="background:#DCDCDC;" + |Isoniazid<ref name="pmid2304098">{{cite journal |vauthors=Watkins RC, Hambrick EL, Benjamin G, Chavda SN |title=Isoniazid toxicity presenting as seizures and metabolic acidosis |journal=J Natl Med Assoc |volume=82 |issue=1 |pages=57, 62, 64 |date=January 1990 |pmid=2304098 |pmc=2625939 |doi= |url=}}</ref> | ! colspan="2" align="center" style="background:#DCDCDC;" + |[[Isoniazid]]<ref name="pmid2304098">{{cite journal |vauthors=Watkins RC, Hambrick EL, Benjamin G, Chavda SN |title=Isoniazid toxicity presenting as seizures and metabolic acidosis |journal=J Natl Med Assoc |volume=82 |issue=1 |pages=57, 62, 64 |date=January 1990 |pmid=2304098 |pmc=2625939 |doi= |url=}}</ref> | ||
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* [[Ataxia]] | * [[Ataxia]] | ||
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! colspan="2" align="center" style="background:#DCDCDC;" + |Acetazolamide<ref name="TeppemaBalanos2007">{{cite journal|last1=Teppema|first1=Luc J.|last2=Balanos|first2=George M.|last3=Steinback|first3=Craig D.|last4=Brown|first4=Allison D.|last5=Foster|first5=Glen E.|last6=Duff|first6=Henry J.|last7=Leigh|first7=Richard|last8=Poulin|first8=Marc J.|title=Effects of Acetazolamide on Ventilatory, Cerebrovascular, and Pulmonary Vascular Responses to Hypoxia|journal=American Journal of Respiratory and Critical Care Medicine|volume=175|issue=3|year=2007|pages=277–281|issn=1073-449X|doi=10.1164/rccm.200608-1199OC}}</ref> | ! colspan="2" align="center" style="background:#DCDCDC;" + |[[Acetazolamide]]<ref name="TeppemaBalanos2007">{{cite journal|last1=Teppema|first1=Luc J.|last2=Balanos|first2=George M.|last3=Steinback|first3=Craig D.|last4=Brown|first4=Allison D.|last5=Foster|first5=Glen E.|last6=Duff|first6=Henry J.|last7=Leigh|first7=Richard|last8=Poulin|first8=Marc J.|title=Effects of Acetazolamide on Ventilatory, Cerebrovascular, and Pulmonary Vascular Responses to Hypoxia|journal=American Journal of Respiratory and Critical Care Medicine|volume=175|issue=3|year=2007|pages=277–281|issn=1073-449X|doi=10.1164/rccm.200608-1199OC}}</ref> | ||
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! colspan="2" align="center" style="background:#DCDCDC;" + |Amphotericin B<ref name="BatesSu2001">{{cite journal|last1=Bates|first1=D. W.|last2=Su|first2=L.|last3=Yu|first3=D. T.|last4=Chertow|first4=G. M.|last5=Seger|first5=D. L.|last6=Gomes|first6=D. R. J.|last7=Dasbach|first7=E. J.|last8=Platt|first8=R.|title=Mortality and Costs of Acute Renal Failure Associated with Amphotericin B Therapy|journal=Clinical Infectious Diseases|volume=32|issue=5|year=2001|pages=686–693|issn=1058-4838|doi=10.1086/319211}}</ref> | ! colspan="2" align="center" style="background:#DCDCDC;" + |[[Amphotericin B]]<ref name="BatesSu2001">{{cite journal|last1=Bates|first1=D. W.|last2=Su|first2=L.|last3=Yu|first3=D. T.|last4=Chertow|first4=G. M.|last5=Seger|first5=D. L.|last6=Gomes|first6=D. R. J.|last7=Dasbach|first7=E. J.|last8=Platt|first8=R.|title=Mortality and Costs of Acute Renal Failure Associated with Amphotericin B Therapy|journal=Clinical Infectious Diseases|volume=32|issue=5|year=2001|pages=686–693|issn=1058-4838|doi=10.1086/319211}}</ref> | ||
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! colspan="2" align="center" style="background:#DCDCDC;" + | | ! colspan="2" align="center" style="background:#DCDCDC;" + |[[Carbon monoxide poisoning]]<ref name="pmid10333448">{{cite journal |vauthors=Piantadosi CA |title=Diagnosis and treatment of carbon monoxide poisoning |journal=Respir Care Clin N Am |volume=5 |issue=2 |pages=183–202 |date=June 1999 |pmid=10333448 |doi= |url=}}</ref> | ||
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! colspan="2" align="center" style="background:#DCDCDC;" + |Cyanide<ref name="pmid12352039">{{cite journal |vauthors=Baud FJ, Borron SW, Mégarbane B, Trout H, Lapostolle F, Vicaut E, Debray M, Bismuth C |title=Value of lactic acidosis in the assessment of the severity of acute cyanide poisoning |journal=Crit. Care Med. |volume=30 |issue=9 |pages=2044–50 |date=September 2002 |pmid=12352039 |doi=10.1097/01.CCM.0000026325.65944.7D |url=}}</ref> | ! colspan="2" align="center" style="background:#DCDCDC;" + |[[Cyanide poisoning]]<ref name="pmid12352039">{{cite journal |vauthors=Baud FJ, Borron SW, Mégarbane B, Trout H, Lapostolle F, Vicaut E, Debray M, Bismuth C |title=Value of lactic acidosis in the assessment of the severity of acute cyanide poisoning |journal=Crit. Care Med. |volume=30 |issue=9 |pages=2044–50 |date=September 2002 |pmid=12352039 |doi=10.1097/01.CCM.0000026325.65944.7D |url=}}</ref> | ||
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Revision as of 15:14, 22 May 2018
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sadaf Sharfaei M.D.[2]
Overview
Metabolic acidosis is occured in different situations such as poisoning, ketoacidosis, renal, gastrointestinal, cardiac, endocrine, and systemic diseases.
Metabolic Acidosis Differential Diagnosis
Differential diagnosis of metabolic acidosis is as follow:[1][2][3][4]
To review differential diagnosis of high anion gap metabolic acidosis, click here.
To review differential diagnosis of high osmolar gap metabolic acidosis, click here.
To review differential diagnosis of metabolic acidosis and lactic acidosis, click here.
Category | Disease | Mechanism | Clinical | Paraclinical | Gold standard diagnosis | Other findings | |||||||||||||||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Symptoms | Signs | Lab data | |||||||||||||||||||||||||||||||
ABG | CBC | Chemistry | Renal | U/A | |||||||||||||||||||||||||||||
↑ acid production |
Loss of bicarbonate |
↓ renal acid excretion |
Fever | N/V | Diarrhea | Dyspnea | Toxic/ill | BP | Dehydration | LOC | HCO3− | paCO2 | O2 | WBC | Hb | BS | Cl− | K+ | Na+ | Ketones | Lactic acid | Serum AG[5] | Osmolar gap[6] | Bun | Cr | Urine pH | Urine AG | Urine ketone | |||||
Toxin/Medication[7] | Alcohol[8][9] | + | − | − | − | + | − | − | + | ↓ ↑ | + | ↓ | ↓ | ↓ | ↓ | Nl | Nl | ↑ | ↑ | ↑ | Nl | + | ↑ | ↑ | ↑ | Nl or ↑ | Nl or ↑ | ↓ | + | + | Clinical |
| |
+ | − | − | − | + | − | − | + | ↓ | + | ↓ | ↓ | ↓ | ↓ | Nl | Nl | Nl | ↑ | ↑ | Nl | + | ↑ | Nl | ↑ | Nl | Nl or ↑ | ↓ | + | + | Clinical | ||||
Toluene[11] | + | − | + | − | + | − | − | + | ↓ | − | ↓ | ↓↓ | ↓ | Nl | Nl | Nl | Nl | Nl | ↓ | Nl | − | ↑ | Nl or ↑ | Nl | ↑ | ↑ | ↓ | − | + | Clinical |
| ||
Salicylates[12] | + | − | − | − | + | − | + | + | ↓ | + | ↓ | ↓ | ↓↓ | ↓ | Nl | Nl | Nl to ↓ | Nl | ↓ | Nl | − | ↑ | ↑ | ↑ | ↑ | ↑ | ↓ | − | − | Clinical and elevated serum salicylate level |
| ||
Metformin[13] | + | − | − | − | + | − | − | + | ↓ | ± | Agitated | ↓ | ↓ | Nl | Nl to ↑ | ↓ | ↓ | Nl | Nl | Nl | Nl | ↑ | ↑ | ↑ | Nl or ↑ | Nl | ↓ | − | − | Clinical | |||
Isoniazid[14] | + | − | − | − | + | − | − | + | ↑ | + | Agitated | ↓ | ↓ | Nl | Nl | ↓ | Nl | Nl | Nl | Nl | Nl | ↑ | ↑ | Nl | Nl or ↑ | Nl | ↓ | − | − | Clinical | |||
Acetazolamide[15] | − | + | − | − | − | − | − | − | ↓ | + | Nl | ↓ | ↓ | Nl to ↓ | Nl | Nl | Nl | Nl | Nl | Nl | Nl | Nl | Nl | Nl | Nl or ↑ | Nl | ↓ | − | − | Clinical | |||
Amphotericin B[16] | − | − | + | − | + | + | − | + | ↓ | + | ↓ | ↓ | ↓ | Nl to ↓ | Nl | Nl | Nl | Nl | Nl | Nl | Nl | Nl | Nl | Nl | ↑ | ↑ | ↓ | − | − | Clinical | |||
Carbon monoxide poisoning[17] | + | − | + | − | ± | − | − | + | Nl | − | ↓↓ | ↓ | ↓ | Nl to ↓ | Nl | Nl | Nl | Nl | Nl | Nl | Nl | ↑ | ↑ | Nl | Nl | Nl | ↓ | − | − | Clinical | |||
Cyanide poisoning[18] | + | − | − | − | + | − | − | + | ↓ | ± | ↓↓ | ↓ | ↓ | ↓ | Nl to ↑ | ↓ | Nl | Nl | Nl | Nl | Nl | ↑ | ↑ | Nl | Nl or ↑ | Nl | ↓ | − | − | Blood cyanide concentration | |||
Category | Disease | ↑ acid production |
Loss of bicarbonate |
↓ renal acid excretion |
Fever | N/V | Diarrhea | Dyspnea | Toxic/ill | BP | Dehydration | LOC | HCO3− | paCO2 | O2 | WBC | Hb | BS | Cl− | K+ | Na+ | Ketones | Lactic acid | Serum AG | Osmolar gap | Bun | Cr | Urine pH | Urine AG | Urine ketone | Gold standard diagnosis | Other findings | |
Ketoacidosis | Diabetic[19] | + | − | − | + | + | + | + | + | ↓ | + | ↓ | ↓ | ↓ | Nl to ↓ | ↑ | Nl to ↑ | ↑↑ | Nl | ↓ | ↓ | ↑ | ↑ | ↑ | ↑ | Nl to ↑ | Nl | ↓ | + | + | Clinical + hyperglycemia + ketosis | ||
Starvation[20] | + | − | − | − | + | − | − | + | ↓ | + | ↓ | ↓ | ↓ | Nl | Nl | Nl | Nl to ↓ | Nl | ↓ | ↓ | ↑ | Nl | ↑ | Nl | Nl | Nl | Nl | + | − | Clinical | |||
Alcoholic (Ethanol)[21] | + | − | − | − | + | ± | − | + | ↓ ↑ | + | Agitated | ↓ | ↓ | ↓ | Nl to ↑ | Nl to ↑ | ↓ Nl ↑ | Nl | ↓ | ↓ | ↑↑ | ↑ | ↑ | ↑↑ | ↑ | Nl | ↓ | + | + | Clinical + ketosis |
| ||
Systemic | Sepsis[22] | + | − | − | + | + | − | + | + | ↓ ↑ | + | ↓ | ↓ | ↓ | Nl to ↓ | ↑ | Nl | Nl | Nl | ↑ | ↓ | Nl | Nl to ↑ | Nl | Nl | ↑ | ↑ | Nl | − | − | Clinical and lab finding | ||
Ischemia[23] | + | − | − | − | + | − | + | + | ↓ | + | − | ↓ | ↓ ↑ | Nl to ↓ | Nl to ↑ | Nl | Nl | Nl | ↑ | ↓ | Nl | Nl to ↑ | Nl | Nl | Nl to ↑ | Nl to ↑ | Nl | − | − | Clinical and lab finding | |||
Lactic acidosis[24] | + | − | − | ± | + | − | − | + | ↓ ↑ | ± | Agitated | ↓ | ↓ | ↓ | Nl to ↑ | ↓ | Nl | Nl | Nl | Nl | Nl | ↑ | ↑ | ↑ | Nl or ↑ | Nl | ↓ | − | − | Clinical and lab finding | |||
Renal | Uremia[25] | − | − | + | + | + | − | − | + | ↓ ↑ | ± | ↓ | ↓ | ↓ | Nl to ↓ | ↑ | ↓ | Nl | Nl | ↑ | ↑ | Nl | Nl | ↑ | ↑ | ↑ | ↑ | ↓ | + | − | Clinical and lab finding | ||
Renal failure[26] | − | − | + | − | + | − | − | + | ↓ | + | ↓ | ↓ | ↓ | Nl to ↓ | ↑ | ↓ | Nl | ↑ | ↑ | ↓ | Nl | Nl | ↑ | ↑ | ↑ | ↑ | ↓ | − | − | Renal function test | |||
Renal tubular acidosis[27] | Type I[28] | − | − | + | ± | ± | − | − | − | ↓ ↑ | − | − | ↓ | ↓ | Nl | Nl | Nl | Nl | ↑ | ↓ | ↓ | Nl | Nl | Nl | Nl | ↑ | ↑ | ↑ | + | − | Clinical and lab finding |
| |
Type II | − | + | − | ± | ± | − | − | − | ↓ ↑ | − | − | ↓ | ↓ | Nl | Nl | Nl | Nl | ↑ | ↓ | Nl | Nl | Nl | Nl | Nl | Nl | Nl | Nl | − | − | Clinical and lab finding | |||
Type IV | − | − | + | ± | ± | ± | − | − | ↓ | − | − | ↓ | ↓ | Nl | Nl | Nl | Nl | ↑ | ↑ | Nl | Nl | Nl | Nl | Nl | Nl | Nl | Nl | + | − | Clinical and lab finding | |||
Category | Disease | ↑ acid production |
Loss of bicarbonate |
↓ renal acid excretion |
Fever | N/V | Diarrhea | Dyspnea | Toxic/ill | BP | Dehydration | LOC | HCO3− | paCO2 | O2 | WBC | Hb | BS | Cl− | K+ | Na+ | Ketones | Lactic acid | Serum AG | Osmolar gap | Bun | Cr | Urine pH | Urine AG | Urine ketone | Gold standard diagnosis | Other findings | |
Heart | Heart failure[29] | + | + | − | − | ± | − | + | + | ↓ ↑ | + | − | ↓ | ↓ ↑ | ↓ | Nl | Nl | Nl | Nl | ↓ | ↓ | Nl | Nl | Nl | Nl | Nl to ↑ | Nl to ↑ | Nl | − | − | Clinical + echocardiogram |
| |
MI[30] | + | − | − | − | + | − | + | + | ↓ ↑ | − | ↓ | ↓ | ↓ ↑ | Nl to ↓ | Nl to ↑ | Nl | Nl | Nl | ↑ | ↓ | Nl | ↑ | Nl | Nl | Nl to ↑ | Nl to ↑ | Nl | − | − | Clinical + ECG | |||
GI | Diarrhea[31] | − | + | − | ± | + | + | − | + | ↓ | + | − | ↓ | ↓ | Nl | Nl | ↓ | ↓ | ↑ | ↑ | Nl | Nl | Nl | Nl | Nl | ↑ | Nl | Nl | − | − | Stool exam | ||
Hyperalimentation[32] | + | + | − | − | − | + | − | − | Nl | − | − | ↓ | ↓ | Nl | Nl | ↓ | Nl | ↑ | ↑ | Nl | Nl | Nl | Nl | Nl | Nl | Nl | Nl | − | − | Clinical | |||
Liver failure[33] | − | + | − | − | + | + | − | + | ↓ | + | Confused | ↓ | ↓ | Nl | Nl | ↓ | ↓ ↑ | ↑ | ↓ | ↓ | Nl | Nl | Nl | Nl | Nl | Nl | Nl | − | − | Liver biopsy | |||
Endocrine | Hyperparathyroidism[34] | − | + | + | − | + | − | − | − | Nl | + | Confused | ↓ | ↓ | Nl | Nl | Nl | Nl | Nl | Nl | Nl | Nl | Nl | Nl | Nl | Nl to ↑ | Nl | Nl | − | − | PTH level | ||
Addison's disease[35] | − | + | − | − | + | + | − | − | ↓ | + | Irritable | ↓ | ↓ | Nl | Nl | Nl | ↓ | Nl | ↑ | ↓ | Nl | Nl | Nl | Nl | Nl | Nl | Nl | − | − | Hormone level | |||
Category | Disease | ↑ acid production |
Loss of bicarbonate |
↓ renal acid excretion |
Fever | N/V | Diarrhea | Dyspnea | Toxic/ill | BP | Dehydration | LOC | HCO3− | paCO2 | O2 | WBC | Hb | BS | Cl− | K+ | Na+ | Ketones | Lactic acid | Serum AG | Osmolar gap | Bun | Cr | Urine pH | Urine AG | Urine ketone | Gold standard diagnosis | Other findings |
References
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- ↑ Howard RD, Bokhari S. PMID 28613672. Vancouver style error: initials (help); Missing or empty
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(help) - ↑ Ganesh K, Sharma RN, Varghese J, Pillai MG (2016). "A profile of metabolic acidosis in patients with sepsis in an Intensive Care Unit setting". Int J Crit Illn Inj Sci. 6 (4): 178–181. doi:10.4103/2229-5151.195417. PMC 5225760. PMID 28149822.
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