Alcohol/Starvation-induced keto-acidosis & Lactic acidosis Flashcards

1
Q

what is a typical presentation of alcohol-induced keto-acidosis

A

older patient, heavy alcohol intake for many years, abdo pain, vomiting,

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2
Q

what is typically seen on examination of alcohol-induced keto-acidosis

A

dry and difficult to rouse, hypotensive, tachypnoeic

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3
Q

what biochemical markers are raised in alcohol/starvation-induced keto-acidosis

A

lactate, ketones, anion gap

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4
Q

what biochemical markers are low in alcohol/starvation-induced keto-acidosis

A

pH, bicarbonate, glucose may be low(usually normal)

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5
Q

describe the levels of dehydration in alcohol/starvation-induced keto-acidosis, and in lactic acidosis

A

alcohol/starvation = very dehydrated dehydrated

lactic acidosis = no dehydration

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6
Q

what is the normal range for lactate

A

o.6 to 1.2mmol/l

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7
Q

in what states is lactate levels low and raised

A

lowest in fasted state

raised in exercise, can be high as 10mmol/l

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8
Q

what is the normal range of the anion gap, and what is it useful for

A

10-18mmol/l, useful in determining cause of acidosis

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9
Q

what is the anion gap

A

(Na+ + K+) - (HCO3- + Cl-)

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10
Q

what is the difference between hyperlactataemia and lactic acidosis

A

both have high lactate but pH <7.3 in lactic acidosis

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11
Q

what is type A of lactic acidosis associated with

A

hypoxaemia, eg infarcted tissue, cardiogenic shock, sepsis, haemorrhage etc.

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12
Q

what is type B of lactic acidosis associated with

A

liver disease, leukaemic states, diabetes

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13
Q

what are some of the clinical features of lactic acidosis

A

hyperventilation, mental confusion, stupor or coma if severe

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14
Q

what lab findings are seen in lactic acidosis

A

reduced bicarbonate, raised anion gap, absence of ketones, raised phosphate pH low, glucose variable(often high)

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15
Q

what is involved in the management of lactic acidosis

A

treat underlying cause, fluids, antibiotics, withdraw offending medication

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