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How Do I Approach the Patient with High Lactate? - Differential Diagnosis for Lactic Acidosis

#Lactic #LacticAcidosis
- Differential Diagnosis ... #Differential # ... Table #Diagnosis ... #CriticalCare # ... Causes
Lactic Acidosis - Differential Diagnosis Framework

Type A: Impaired O2 Delivery (DO2)
 • Decreased O2 Delivery: Hypotension
- Differential Diagnosis ... Impaired O2 Delivery (DO2 ... Leukemia/Lymphoma), Diabetes ... #Acidosis #Differential ... #Diagnosis #criticalcare
Causes of Lactate Elevation, Lactic Acidosis - Differential Diagnosis

The most common causes of hyperlactatemia are usually:
Acidosis - Differential ... Diagnosis The ... excretion (e.g., urine ... • Type B1: - Diabetes ... #Diagnosis #causes
Metabolic Alkalosis - Urinary Chloride Algorithm
Cl- responsive metabolic alkalosis
 • Kidney loss of Cl-
metabolic acidosis • Diabetic ... ketoacidosis • D-lactic ... the indicated causes ... Algorithm #nephrology #differential ... #diagnosis
Hyperkalemia - Differential Diagnosis Framework

PseudoHyperkalemia:
 • Lab error
 • Traumatic venipuncture
 • Hemolysis, thrombocytosis, leukocytosis
 •
Hyperkalemia - Differential ... Diagnosis Framework ... Poorly controlled DM ... (Uncontrolled diabetes ... #diagnosis #causes
Causes of Hyperkalemia - Reduced Excretion - Differential Diagnosis Algorithm

Reduced flow through distal nephron - TTKG
Causes of Hyperkalemia ... nephron - TTKG > 7, Urine ... Low EABV (e.g., CHF ... Aldosterone • Diabetic ... #Causes
Hyperkalemia - Differential Diagnosis Framework

PseudoHyperkalemia:
 • Lab error
 • Traumatic venipuncture
 • Hemolysis, thrombocytosis, leukocytosis
 •
Hyperkalemia - Differential ... Diagnosis Framework ... Poorly controlled DM ... (Uncontrolled diabetes ... #diagnosis #causes
It is important to recognize Acute Decompensated Heart Failure (ADHF) as more than just simply a
status and low urine ... the determined cause ... #diagnosis #differential ... #heartfailure #chf ... #criticalcare #
Hyperkalemia - Diagnosis and Management - GrepMed Handbook

S/Sx: Most pts asymptomatic. Weakness, cramping, nausea, paresthesias, palpitations,
transfusions), ↓insulin (DM ... Na delivery): CHF ... lysis) ± Urine ... only if no clear cause ... Elimination (see Table