Anion Gap Metabolic Acidosis (AGMA) Differential Diagnosis - MUDPILES and GOLDMARK M - Methanol U - Uremia D - Diabetic Ketoacidosis (DKA) P - Phenformin, Paraldehyde I - INH, Iron L - Lactic acid E - Ethanol, Ethylene glycol S - Salicylates G - Glycols (propylene glycol, ethylene glycol) O - Oxoproline (acetaminophen use) L - L-lactate D - D-lactate (short bowel syndrome) M - Methanol A - Aspirin R - Renal failure K - Ketoacidosis (diabetic/alcohol/starvation) While MUDPILES has been taught traditionally, GOLDMARK is more reflective of the differential diagnosis of anion gap acidosis encountered in the modern day. Iron overdose is rare and is usually clinically obvious while INH (isoniazid), phenformin and paraldehyde toxicity are uncommon. D-lactate, 5-oxoproline and propylene glycol have also emerged as causes of AGMA. #MUDPILES #GOLDMARK #Anion #Gap #Metabolic #Acidosis #AGMA #Differential #Diagnosis
