Podcast 559: Metabolic Acidosis

Podcast 559: Metabolic Acidosis

Contributor: Dylan Luyten, MD

Educational Pearls

  • Acidosis can be caused by a respiratory, metabolic, or mixed source
  • A respiratory acidosis will have a low serum pH and elevated bicarbonate if it's chronic, but most importantly end tidal CO2 or arterial CO2 will be high.
  • With a metabolic acidosis we expect to see a low serum pH and low serum bicarbonate.
  • Once it's determined a patient is in a metabolic acidosis, we need to determine if it's an elevated anion gap or normal anion gap acidosis. Anion gap is calculated by subtracting the serum anions from the cations, or serum sodium minus the serum chloride and CO2 (Na-(Cl+CO2)). A normal gap is 6-10, gaps over 10 have an elevated anion gap acidosis.
  • The causes of an elevated anion gap acidosis can be remembered with MUDPILES mnemonic (Methanol, Uremia (renal failure), Diabetes/DKA, Paraldehyde, Isoniazid, Lactate, Ethanol/Ethylene glycol, salicylates/aspirin).
  • So when you suspect an elevated gap acidosis you need to evaluate for all causes, so you need to get an venous or arterial blood gas along with lactate, salicylate, and Tylenol levels.

References

  1. Vanmassenhove J. Lameire N. Approach to the patient presenting with metabolic acidosis. Acta Clin Belg. 2019 Feb;74(1):21-27. doi: 10.1080/17843286.2018.1547245. Epub 2018 Nov 24.
  2. Burger MK, Schaller DJ. Physiology, Acidosis, Metabolic. [Updated 2019 Jun 4]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK482146/

Summarized by Jackson Roos, MS3 | Edited by Erik Verzemnieks, MD

Jaksot(1145)

Laboring Under Pressure Episode 3: Hypertensive Disorders of Pregnancy with Dr. Kiersten Williams

Laboring Under Pressure Episode 3: Hypertensive Disorders of Pregnancy with Dr. Kiersten Williams

Contributor: Kiersten Williams MD, Travis Barlock MD, Jeffrey Olson MS3 Show Pearls Hypertensive disorders of pregnancy are one of the leading causes of maternal mortality worldwide. Hypertension ...

12 Syys 202428min

Episode 920: Pediatric Growth Estimates

Episode 920: Pediatric Growth Estimates

Contributor: Sean Fox, MD Educational Pearls: Newborns may lose up to 10% of their birth weight in the first week of life Weight loss is greatest in exclusively breastfed infants Should regain ...

9 Syys 20246min

Episode 919: EKG Criteria for Adenosine

Episode 919: EKG Criteria for Adenosine

Contributor: Travis Barlock, MD Educational Pearls: SVT: supraventricular tachycardia Pharmacotherapy for SVT includes drugs that block the AV node, such as adenosine EKG criteria before adeno...

4 Syys 20241min

Episode 918: Automated Blood Pressure Cuffs

Episode 918: Automated Blood Pressure Cuffs

Contributor: Aaron Lessen, MD Educational Pearls: How does an automated blood pressure cuff work? Automated blood pressure cuffs work differently than taking a manual blood pressure. While taking ...

26 Elo 20242min

Episode 917: Heat-Related Illnesses

Episode 917: Heat-Related Illnesses

Contributor: Megan Hurley, MD Educational Pearls: Heat cramps Occur due to electrolyte disturbances Most common electrolyte abnormalities are hyponatremia and hypokalemia Heat edema Caus...

19 Elo 20244min

Episode 916: Central Cord Syndrome

Episode 916: Central Cord Syndrome

Contributor: Taylor Lynch, MD Educational Pearls: What is Central Cord Syndrome (CCS)? Incomplete spinal cord injury caused by trauma that compresses the center of the cord More common in hyperext...

12 Elo 20246min

Episode 915: Severe Burn Injuries

Episode 915: Severe Burn Injuries

Contributor: Megan Hurley, MD Educational Pearls: Initial assessment of patients with severe burn injuries begins with ABCs Airway: consider inhalation injury Breathing: circumferential burns ...

5 Elo 20244min

Podcast 914: Neuroleptic Malignant Syndrome (NMS)

Podcast 914: Neuroleptic Malignant Syndrome (NMS)

Contributor: Taylor Lynch, MD Educational Pearls: What is NMS? Neuroleptic Malignant Syndrome Caused by anti-dopamine medication or rapid withdrawal of pro-dopamenergic medications Mechanism is ...

29 Heinä 202410min

Suosittua kategoriassa Tiede

tiedekulma-podcast
rss-mita-tulisi-tietaa
rss-poliisin-mieli
rss-duodecim-lehti
docemilia
filocast-filosofian-perusteet
rss-ammamafia
rss-luontopodi-samuel-glassar-tutkii-luonnon-ihmeita
rss-sosiopodi
utelias-mieli
radio-antro
rss-astetta-parempi-elama-podcast
rss-tiedetta-vai-tarinaa