ICM - Lactate

Question 1

Definition of hyperlactataemia

Answer 1

> 2.0 mmol/L

Question 2

What two things are lactate made from?

Answer 2

Glucose| Alanine

Question 3

What is the intermediate substrate of lactate| What catalyses the equilibrium between this and lactate

Answer 3

Pyruvate| Lactate dehydrogenase

Question 4

How is glucose metabolised to lactate| 2 pathways

Answer 4

Glycolysis| Pentose-5-phosphate pathway

Question 5

How is pyruvate converted to glucose

Answer 5

Gluconeogenesis in the liver and kidney

Question 6

What happens to pyruvate during the TCA cycle

Answer 6

Becomes Acetyl CoA| This then produces ATP

Question 7

Production rate of lactate and where is it produced

Answer 7

0.8mmol/Kg| Skeletal muscle, skin, brain, intestine and RBC

Question 8

Describe the two ways in which lactate may accumulate

Answer 8

1) increaed production| 2) impaired clearence (liver disease)

Question 9

Classify Lactic Acidosis

Answer 9

Cohen and Woods Classification Type A and BDepends on the presence (A) or absence (B) of tissue hypoxia

Question 10

Causes of type A lactic acidosis

Answer 10

Hypoperfusion - shock (sepsis, cardiogenic, hypovolaemic)
Hypotension
Cardiac arrest
Regional hypoperfusion (mesenteric)
Reduced DO2 delivery
Reduced utilisation - carbon monoxide