Metabolic Acidosis/Alkalosis Flashcards
HAGMA
High Anion Gap Metabolic Acidosis
What is the differential diagnosis pneumonic for HAGMA?
GOLDMARK
DDX for HAGMA
GOLDMARK
- Glycols
- Oxoproline
- L and D Lactic Acidosis
- Methanol
- Aspirin
- Renal failure
- Ketoacidosis
DDX for HAGMA
GOLDMARK
- Glycols
- Oxoproline
- L and D lactic acidosis
- Methanol
- Aspirin
- Renal failure
- Ketoacidosis
What DDX for HAGMA are differentials if the Osmolar Gap is increased?
Glycols
Methanol
NAGMA
Normal Anion Gap Metabolic Acidosis
What is the differential diagnosis pneumonic for NAGMA?
DURHAAM
DDX for NAGMA
DURHAAM
- Diarrhea
- Ureteral diversion
- Renal Tubular Acidosis
- Hyperalimentation
- Acetazolamide
- Addison’s disease
- Misc.
DDX for NAGMA
DURHAAM
- Diarrhea
- Ureteral diversion
- Renal Tubular Acidosis
- Hyperalimentation
- Acetazolamide
- Addisons disease
- Misc.
What defines Renal Tubular Acidosis (RTA)?
Net acid excretion by the kidneys is impaired
Net acid excretion by the kidneys is impaired
RTA
renal tubular acidosis
When can RTA NOT be diagnosed?
In the setting of AKI
What defines Distal RTA?
Decreased net H+ secretion in the distal tubules
Decreased net H+ secretion in the distal tubules
Distal (type 1) RTA
What 2 things may cause Distal RTA?
Sjogren’s syndrome
Sniffing glue
What is a common manifestation of Distal RTA?
Nephrolithiasis
What is the result of the Urine Anion Gap with Distal RTA?
(+)
– unable to acidify urine
What defines Proximal RTA?
Decreased net HCO3- reabsorption in the proximal tubule
Decreased net HCO3- reabsorption in the proximal tubule
Proximal (type 2) RTA
What 3 things may cause Proximal RTA?
Fanconi
Multiple myeloma
Cystinosis
What is the result of the Urine Anion Gap with Proximal RTA?
(-)
With Type 1 and Type 2 RTA, the urine pH is usually?
Less than 5.5
With Type 1 and Type 2 RTA, what will the level of K+ be?
Hypokalemia
What defines Type 4 RTA?
Decreased Aldosterone which causes decreased H+ and K+ secretion in the collecting duct
