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Latest revision as of 14:55, 13 October 2020

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Alkalosis refers to a condition reducing hydrogen ion concentration of arterial blood plasma (alkalemia) through the loss of acids or retention of bicarbonate. Generally alkalosis is said to occur when pH of the blood exceeds 7.45. The opposite condition is acidosis.

Classification

More specifically, alkalosis can refer to:

Causes

Common Causes

The main cause of respiratory alkalosis is hyperventilation, resulting in a loss of carbon dioxide. Compensatory mechanisms for this would include increased dissociation of the carbonic acid buffering intermediate into hydrogen ions, and the related consumption of bicarbonate, both of which would lower blood pH.

Metabolic alkalosis can be caused by prolonged vomitting, resulting in a loss of hydrochloric acid with the stomach content. Severe dehydration, and the consumption of alkali are other causes. Compensatory mechanism for metabolic alkalosis involve slowed breathing by the lungs to increase serum carbon dioxide, a condition leaning toward respiratory acidosis. As respiratory acidosis often accompanies the compensation for metabolic alkalosis, and visa versa, a delicate balance is created between these two conditions.

Causes in Alphabetical Order

Metabolic Alkalosis

Administration of citrates
After respiratory acidosis
Alkali therapy for stomach problems
Bartter's Syndrome
Conn syndrome
Cushing's Syndrome
Cystic Fibrosis
Diarrhea
Gastric juice drainage
Hepatic coma
Hyperemesis gravidarum
Milk Alkali Syndrome
Mineralcorticoid therapy
Overcorrection of acidosis with bicarbonates
Renal potassium loss
Vomiting

Pathophysiology

Metabolic Alkalosis

It is thought that metabolic [alkalosis] is the result of the shift of hydrogen ions intracellularly, reduced blood volume, loss of gastric acid, and extracellular volume expansion.

Shift of hydrogen ions intracellularly

Electrolyte imbalance like hypokalemia causes a shift of hydrogen ions intracellular caused defect of protons and an increase in bicarbonate ion concentration. ^[1]

Reduced Blood volume

Volume depletion results in reduced glomerular filtration rate. This stimulates the production of Angiotensin II, sympathetic nervous system activation, and aldosterone secretion.
The sympathetic nervous system and angiotensin II causes increased absorption of sodium in proximal convoluted tubules via sodium hydrogen exchange.
Aldosterone acts primarily on the principal cells of the late distal convoluted tubule and collecting ducts. It causes sodium and water retention in exchange for potassium and hydrogen ions secretion. The loop and thiazide diuretics also act by similar mechanisms of action.^[2]

Loss of Gastric acid

The hydrogen ions are primarily secreted in large amounts in the gastric juice. The hydrogen ions are secreted via active transport mediated by hydrogen potassium ATPase pump. Excessive vomiting causes loss of a large amount of gastric juice with depletion of hydrogen and chloride from the body.

Extracellular volume expansion

Primary hyperaldosteronism (Conn’s syndrome) causes increased sodium reabsorption with the resultant increase in extracellular volume. The patient may be hypertensive or normotensive. The hypokalemia caused by the action of aldosterone causes increased reabsorption of sodium bicarbonate in the proximal convoluted tubule with a worsening of metabolic alkalosis.

Respiratory Alkalosis

It is thought that the respiratory alkalosis is the result of hyperventilation. The causes of hyperventilation can be due to increased stimulation of the medullary respiratory center, low oxygen tension in blood, lung pathologies, and iatrogenic. The stimulation of the respiratory center occurs due to stroke, head injury, metabolic disease like hyperthyroidism, emotional stress, panic attack, and side effect of medications like aspirin. The low oxygen tension in the blood causes stimulation of the respiratory center resulting in hyperventilation and hypocapnia. The acute attack of asthma, COPD, pulmonary embolism can cause tachypnea with increase loss of carbon dioxide.

Epidemiology and Demographics

The prevalence of alkalosis ranges from 32,727 to 80,000 per 100,000 in hospitalized patients with an acid-base metabolic disorder. ^[3]^[4]
The prevalence of alkalosis is approximately 44,046 per 100,000 in acute heart failure patients. ^[5]

Differential Diagnosis

Differential diagnosis of metabolic alkalosis is as follow:

Disease	Clinical						Paraclinical												Gold standard diagnosis	Other findings
	Symptoms			Signs			Lab data
	Symptoms			Signs			ABG			Chemistry					Enzyme	Renal function
	fatigability	Muscle weakness	Muscle paresthesia	Cardiac arrythmia	Hypotension	Dehydration	HCO₃⁻	paCO₂	O₂	Cl⁻	K⁺	Na⁺	Ca⁺	Mg⁺	Renin	Bun	Cr	Urine Cl⁻
Vomiting^[6]	+	+	+	-	+	+	↑	↑	Nl	↓	↓	↑	Nl	Nl	↑	Nl to ↑	Nl	↓	Clinical manifestations	Not applicable
Nasogastric tube suction^[7]	+	+	+	-	+	+	↑	↑	Nl	↓	↓	↑	Nl	Nl	↑	Nl to ↑	Nl	↓	Clinical manifestations	GERD Pulmonary aspiration
Chronic laxative abuse	+	−	−	-	+	+	↑	↑	Nl	↓	↓	↓	↓	↓	↓	Nl to ↑	Nl	↓	Medication history	Abdominal cramps, large volume diarrhea
Villous adenoma^[8]	+	+	+	+	+	+	↑	↑	Nl	↓	↓	↓	↓	↓	↑	Nl to ↑	Nl	↑	Colonoscopy	Metabolic acidosis
Loop diuretics^[9]	+	±	-	-	+	−	↑	↑	Nl	↓	↓	↓	↓	↓	↑	↑	↑	↑	Medication history	Not applicable
Thiazide diuretics	+	±	-	-	+	−	↑	↑	Nl	↓	↓	↓	↑	↓	↑	↑	↑	↑	Medication history	Not applicable
Renal artery stenosis^[10]	−	+	+	+	↑	+	↑	↑	↓	↓	↑	↓	↑	Nl	↑	↑	↑	Nl	Clinical manifestations+ imaging	Chronic kidney disease Acute rise in Cr following ACEIs or ARBs
Liddle syndrome^[11]	−	−	−	−	↑	+	↑	↑	Nl	↓	↓↓	↓	Nl	↓	↑	Nl	Nl	Nl	Genetic testing	Not applicable
Cushing's syndrome^[12]	−	−	+	−	↑	+	↑	↑	Nl	↓	↑	↓	↑	Nl	↓	↑	↑	Nl	24−hour urinary cortisol excretion + low−dose dexamethasone suppression test	Obesity Lethargy Hirsutism Menstrual changes
Primary hyperaldosteronism^[13]	−	−	+	−	↑	+	↑	↑	Nl	↓	Nl to ↓	↓	↑	Nl	↓	↑	↑	Nl	Lab findings	Resistant HTN Aldosterone−producing adenomas Bilateral adrenal hyperplasia
Cystic fibrosis^[14]	−	+	−	+	↓	+	↑	↑	Nl	↓	↓	Nl	Nl	Nl	↑	Nl to ↑	Nl	↑	Genetic testing	Fatigue Persistent pulmonary infection Pancreatic insufficiency

Differential diagnosis of respiratory alkalosis is as follow:

Disease

Clinical

Paraclinical

Gold standard diagnosis

Other findings

Symptoms

Signs

ABG

CBC

Imaging

PFTs

Dyspnea on exertion

Orthopnea

Cough

Chest pain

Agitation

loss of consciousness

References

↑ Halperin ML, Scheich A (1994). "Should we continue to recommend that a deficit of KCl be treated with NaCl? A fresh look at chloride-depletion metabolic alkalosis". Nephron. 67 (3): 263–9. doi:10.1159/000187977. PMID 7936014.
↑ Hamm LL, Nakhoul N, Hering-Smith KS (2015). "Acid-Base Homeostasis". Clin J Am Soc Nephrol. 10 (12): 2232–42. doi:10.2215/CJN.07400715. PMC 4670772. PMID 26597304.
↑ Palange P, Carlone S, Galassetti P, Felli A, Serra P (1990). "Incidence of acid-base and electrolyte disturbances in a general hospital: a study of 110 consecutive admissions". Recenti Prog Med. 81 (12): 788–91. PMID 2075281.
↑ Hodgkin JE, Soeprono FF, Chan DM (1980). "Incidence of metabolic alkalemia in hospitalized patients". Crit Care Med. 8 (12): 725–8. doi:10.1097/00003246-198012000-00005. PMID 6778655.
↑ Park JJ, Choi DJ, Yoon CH, Oh IY, Lee JH, Ahn S; et al. (2015). "The prognostic value of arterial blood gas analysis in high-risk acute heart failure patients: an analysis of the Korean Heart Failure (KorHF) registry". Eur J Heart Fail. 17 (6): 601–11. doi:10.1002/ejhf.276. PMID 26096207.
↑ Gan, Tong J.; Meyer, Tricia; Apfel, Christian C.; Chung, Frances; Davis, Peter J.; Eubanks, Steve; Kovac, Anthony; Philip, Beverly K.; Sessler, Daniel I.; Temo, James; Tram??r, Martin R.; Watcha, Mehernoor (2003). "Consensus Guidelines for Managing Postoperative Nausea and Vomiting". Anesthesia & Analgesia: 62–71. doi:10.1213/01.ANE.0000068580.00245.95. ISSN 0003-2999.
↑ Gilbertson, Heather Ruth; Rogers, Elizabeth Jessie; Ukoumunne, Obioha Chukwunyere (2011). "Determination of a Practical pH Cutoff Level for Reliable Confirmation of Nasogastric Tube Placement". Journal of Parenteral and Enteral Nutrition. 35 (4): 540–544. doi:10.1177/0148607110383285. ISSN 0148-6071.
↑ Gennari, F. J.; Weise, W. J. (2008). "Acid-Base Disturbances in Gastrointestinal Disease". Clinical Journal of the American Society of Nephrology. 3 (6): 1861–1868. doi:10.2215/CJN.02450508. ISSN 1555-9041.
↑ Kataoka H (2018). "Dynamic changes in serum chloride concentrations during worsening of heart failure and its recovery following conventional diuretic therapy: A single-center study". Health Sci Rep. 1 (11): e94. doi:10.1002/hsr2.94. PMC 6242367. PMID 30623047.
↑ Safian, Robert D.; Textor, Stephen C. (2001). "Renal-Artery Stenosis". New England Journal of Medicine. 344 (6): 431–442. doi:10.1056/NEJM200102083440607. ISSN 0028-4793.
↑ Salih, Mahdi; Gautschi, Ivan; van Bemmelen, Miguel X.; Di Benedetto, Michael; Brooks, Alice S.; Lugtenberg, Dorien; Schild, Laurent; Hoorn, Ewout J. (2017). "A Missense Mutation in the Extracellular Domain ofαENaC Causes Liddle Syndrome". Journal of the American Society of Nephrology. 28 (11): 3291–3299. doi:10.1681/ASN.2016111163. ISSN 1046-6673.
↑ Araujo Castro, Marta; Marazuela Azpiroz, Mónica (2018). "Two types of ectopic Cushing syndrome or a continuum? Review". Pituitary. doi:10.1007/s11102-018-0894-2. ISSN 1386-341X.
↑ Martell-Claros, Nieves; Abad-Cardiel, María; Alvarez-Alvarez, Beatriz; García-Donaire, José A.; Pérez, Cristina Fernández (2015). "Primary aldosteronism and its various clinical scenarios". Journal of Hypertension. 33 (6): 1226–1232. doi:10.1097/HJH.0000000000000546. ISSN 0263-6352.
↑ Bates CM, Baum M, Quigley R (February 1997). "Cystic fibrosis presenting with hypokalemia and metabolic alkalosis in a previously healthy adolescent". J. Am. Soc. Nephrol. 8 (2): 352–5. PMID 9048354.

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Template:WikiDoc Sources

[pmid7936014-1] Halperin ML, Scheich A (1994). "Should we continue to recommend that a deficit of KCl be treated with NaCl? A fresh look at chloride-depletion metabolic alkalosis". Nephron. 67 (3): 263–9. doi:10.1159/000187977. PMID 7936014.

[pmid26597304-2] Hamm LL, Nakhoul N, Hering-Smith KS (2015). "Acid-Base Homeostasis". Clin J Am Soc Nephrol. 10 (12): 2232–42. doi:10.2215/CJN.07400715. PMC 4670772. PMID 26597304.

[pmid2075281-3] Palange P, Carlone S, Galassetti P, Felli A, Serra P (1990). "Incidence of acid-base and electrolyte disturbances in a general hospital: a study of 110 consecutive admissions". Recenti Prog Med. 81 (12): 788–91. PMID 2075281.

[pmid6778655-4] Hodgkin JE, Soeprono FF, Chan DM (1980). "Incidence of metabolic alkalemia in hospitalized patients". Crit Care Med. 8 (12): 725–8. doi:10.1097/00003246-198012000-00005. PMID 6778655.

[pmid26096207-5] Park JJ, Choi DJ, Yoon CH, Oh IY, Lee JH, Ahn S; et al. (2015). "The prognostic value of arterial blood gas analysis in high-risk acute heart failure patients: an analysis of the Korean Heart Failure (KorHF) registry". Eur J Heart Fail. 17 (6): 601–11. doi:10.1002/ejhf.276. PMID 26096207.

[GanMeyer2003-6] Gan, Tong J.; Meyer, Tricia; Apfel, Christian C.; Chung, Frances; Davis, Peter J.; Eubanks, Steve; Kovac, Anthony; Philip, Beverly K.; Sessler, Daniel I.; Temo, James; Tram??r, Martin R.; Watcha, Mehernoor (2003). "Consensus Guidelines for Managing Postoperative Nausea and Vomiting". Anesthesia & Analgesia: 62–71. doi:10.1213/01.ANE.0000068580.00245.95. ISSN 0003-2999.

[GilbertsonRogers2011-7] Gilbertson, Heather Ruth; Rogers, Elizabeth Jessie; Ukoumunne, Obioha Chukwunyere (2011). "Determination of a Practical pH Cutoff Level for Reliable Confirmation of Nasogastric Tube Placement". Journal of Parenteral and Enteral Nutrition. 35 (4): 540–544. doi:10.1177/0148607110383285. ISSN 0148-6071.

[GennariWeise2008-8] Gennari, F. J.; Weise, W. J. (2008). "Acid-Base Disturbances in Gastrointestinal Disease". Clinical Journal of the American Society of Nephrology. 3 (6): 1861–1868. doi:10.2215/CJN.02450508. ISSN 1555-9041.

[pmid30623047-9] Kataoka H (2018). "Dynamic changes in serum chloride concentrations during worsening of heart failure and its recovery following conventional diuretic therapy: A single-center study". Health Sci Rep. 1 (11): e94. doi:10.1002/hsr2.94. PMC 6242367. PMID 30623047.

[SafianTextor2001-10] Safian, Robert D.; Textor, Stephen C. (2001). "Renal-Artery Stenosis". New England Journal of Medicine. 344 (6): 431–442. doi:10.1056/NEJM200102083440607. ISSN 0028-4793.

[SalihGautschi2017-11] Salih, Mahdi; Gautschi, Ivan; van Bemmelen, Miguel X.; Di Benedetto, Michael; Brooks, Alice S.; Lugtenberg, Dorien; Schild, Laurent; Hoorn, Ewout J. (2017). "A Missense Mutation in the Extracellular Domain ofαENaC Causes Liddle Syndrome". Journal of the American Society of Nephrology. 28 (11): 3291–3299. doi:10.1681/ASN.2016111163. ISSN 1046-6673.

[Araujo_CastroMarazuela_Azpiroz2018-12] Araujo Castro, Marta; Marazuela Azpiroz, Mónica (2018). "Two types of ectopic Cushing syndrome or a continuum? Review". Pituitary. doi:10.1007/s11102-018-0894-2. ISSN 1386-341X.

[Martell-ClarosAbad-Cardiel2015-13] Martell-Claros, Nieves; Abad-Cardiel, María; Alvarez-Alvarez, Beatriz; García-Donaire, José A.; Pérez, Cristina Fernández (2015). "Primary aldosteronism and its various clinical scenarios". Journal of Hypertension. 33 (6): 1226–1232. doi:10.1097/HJH.0000000000000546. ISSN 0263-6352.

[pmid9048354-14] Bates CM, Baum M, Quigley R (February 1997). "Cystic fibrosis presenting with hypokalemia and metabolic alkalosis in a previously healthy adolescent". J. Am. Soc. Nephrol. 8 (2): 352–5. PMID 9048354.

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@@ Line 66: / Line 66: @@
 '''''Differential diagnosis of metabolic alkalosis is as follow''''':
 {|
-! rowspan="4" align="center" style="background:#4479BA; color: #FFFFFF;" + |Category
 ! colspan="2" rowspan="4" align="center" style="background:#4479BA; color: #FFFFFF;" + |Disease
 ! colspan="6" align="center" style="background:#4479BA; color: #FFFFFF;" + |Clinical
@@ Line 82: / Line 81: @@
 ! colspan="3" align="center" style="background:#4479BA; color: #FFFFFF;" + |Renal function
 |-
-! align="center" style="background:#4479BA; color: #FFFFFF;" + |Fever
+! align="center" style="background:#4479BA; color: #FFFFFF;" + |fatigability
-! align="center" style="background:#4479BA; color: #FFFFFF;" + |Dyspnea
+! align="center" style="background:#4479BA; color: #FFFFFF;" + |Muscle weakness
-! align="center" style="background:#4479BA; color: #FFFFFF;" + |Edema
+! align="center" style="background:#4479BA; color: #FFFFFF;" + |Muscle paresthesia
-! align="center" style="background:#4479BA; color: #FFFFFF;" + |Toxic/ill
+! align="center" style="background:#4479BA; color: #FFFFFF;" + |Cardiac arrythmia
-! align="center" style="background:#4479BA; color: #FFFFFF;" + |BP
+! align="center" style="background:#4479BA; color: #FFFFFF;" + |Hypotension
 ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Dehydration
 ! align="center" style="background:#4479BA; color: #FFFFFF;" + |HCO<sub>3</sub><sup>−</sup>
@@ Line 101: / Line 100: @@
 ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Urine Cl<sup>−</sup>
 |-
-! rowspan="3" align="center" style="background:#4479BA; color: #FFFFFF;" + |Exogenous HCO<sub><big>3</big></sub><sup>−</sup> loads
+! colspan="2" align="center" style="background:#DCDCDC;" + |[[Vomiting]]<ref name="GanMeyer2003">{{cite journal|last1=Gan|first1=Tong J.|last2=Meyer|first2=Tricia|last3=Apfel|first3=Christian C.|last4=Chung|first4=Frances|last5=Davis|first5=Peter J.|last6=Eubanks|first6=Steve|last7=Kovac|first7=Anthony|last8=Philip|first8=Beverly K.|last9=Sessler|first9=Daniel I.|last10=Temo|first10=James|last11=Tram??r|first11=Martin R.|last12=Watcha|first12=Mehernoor|title=Consensus Guidelines for Managing Postoperative Nausea and Vomiting|journal=Anesthesia & Analgesia|year=2003|pages=62–71|issn=0003-2999|doi=10.1213/01.ANE.0000068580.00245.95}}</ref>
-! colspan="2" align="center" style="background:#DCDCDC;" + |Acute alkali administration<ref name="MáttarWeil1974">{{cite journal|last1=Máttar|first1=João A.|last2=Weil|first2=Max Harry|last3=Shubin|first3=Herbert|last4=Stein|first4=Leon|title=Cardiac arrest in the critically III|journal=The American Journal of Medicine|volume=56|issue=2|year=1974|pages=162–168|issn=00029343|doi=10.1016/0002-9343(74)90593-2}}</ref>
-| align="center" style="background:#F5F5F5;" + | −
 | align="center" style="background:#F5F5F5;" + | +
-| align="center" style="background:#F5F5F5;" + |−
 | align="center" style="background:#F5F5F5;" + | +
-| align="center" style="background:#F5F5F5;" + |↓
-| align="center" style="background:#F5F5F5;" + | −
-| align="center" style="background:#F5F5F5;" + |↑
-| align="center" style="background:#F5F5F5;" + |↑
-| align="center" style="background:#F5F5F5;" + |↓
-| align="center" style="background:#F5F5F5;" + |↓
-| align="center" style="background:#F5F5F5;" + |↓
-| align="center" style="background:#F5F5F5;" + |↓
-| align="center" style="background:#F5F5F5;" + |↑
-| align="center" style="background:#F5F5F5;" + |Nl
-| align="center" style="background:#F5F5F5;" + |Nl
-| align="center" style="background:#F5F5F5;" + |↑
-| align="center" style="background:#F5F5F5;" + |↑
-| align="center" style="background:#F5F5F5;" + |Nl
-| align="center" style="background:#F5F5F5;" + |Clinical manifestations
-| align="left" style="background:#F5F5F5;" + |
-* Post treatment of [[lactic acidosis]] or [[ketoacidosis]]
-* Increased risk of [[Kidney stone|renal stones]]
-|-
-! colspan="2" align="center" style="background:#DCDCDC;" + |[[Milk-alkali syndrome|Milk−alkali syndrome]]<ref name="Abreo1993">{{cite journal|last1=Abreo|first1=Kenneth|title=The Milk-Alkali Syndrome|journal=Archives of Internal Medicine|volume=153|issue=8|year=1993|pages=1005|issn=0003-9926|doi=10.1001/archinte.1993.00410080065011}}</ref>
-| align="center" style="background:#F5F5F5;" + | −
-| align="center" style="background:#F5F5F5;" + | +
-| align="center" style="background:#F5F5F5;" + |−
 | align="center" style="background:#F5F5F5;" + | +
-| align="center" style="background:#F5F5F5;" + |↓
+| align="center" style="background:#F5F5F5;" + | -
 | align="center" style="background:#F5F5F5;" + | +
-| align="center" style="background:#F5F5F5;" + |↑
-| align="center" style="background:#F5F5F5;" + |↑
-| align="center" style="background:#F5F5F5;" + |↓
-| align="center" style="background:#F5F5F5;" + |↓
-| align="center" style="background:#F5F5F5;" + |↓
-| align="center" style="background:#F5F5F5;" + |↓
-| align="center" style="background:#F5F5F5;" + |↑
-| align="center" style="background:#F5F5F5;" + |↓
-| align="center" style="background:#F5F5F5;" + |↑
-| align="center" style="background:#F5F5F5;" + |↑
-| align="center" style="background:#F5F5F5;" + |↑
-| align="center" style="background:#F5F5F5;" + |Nl
-| align="center" style="background:#F5F5F5;" + |Clinical manifestationsk + exclusion of other causes of [[hypercalcemia]]
-| align="left" style="background:#F5F5F5;" + |
-* Ingestion of large amounts of calcium and absorbable alkali
-* [[Acute kidney injury]]
-|-
-! colspan="2" align="center" style="background:#DCDCDC;" + |[[Transfusion]]<ref name="pmid14712429">{{cite journal |vauthors=Gupta M, Wadhwa NK, Bukovsky R |title=Regional citrate anticoagulation for continuous venovenous hemodiafiltration using calcium-containing dialysate |journal=Am. J. Kidney Dis. |volume=43 |issue=1 |pages=67–73 |date=January 2004 |pmid=14712429 |doi= |url=}}</ref>
-| align="center" style="background:#F5F5F5;" + |±
-| align="center" style="background:#F5F5F5;" + |±
-| align="center" style="background:#F5F5F5;" + | −
-| align="center" style="background:#F5F5F5;" + | +
-| align="center" style="background:#F5F5F5;" + |↓
-| align="center" style="background:#F5F5F5;" + | −
-| align="center" style="background:#F5F5F5;" + |↑
-| align="center" style="background:#F5F5F5;" + |↑
-| align="center" style="background:#F5F5F5;" + |↓
-| align="center" style="background:#F5F5F5;" + |↓
-| align="center" style="background:#F5F5F5;" + |↓/↑
-| align="center" style="background:#F5F5F5;" + |↓
-| align="center" style="background:#F5F5F5;" + |↓
-| align="center" style="background:#F5F5F5;" + |↑
-| align="center" style="background:#F5F5F5;" + |↑
-| align="center" style="background:#F5F5F5;" + |Nl to ↑
-| align="center" style="background:#F5F5F5;" + |Nl to ↑
-| align="center" style="background:#F5F5F5;" + |Nl
-| align="center" style="background:#F5F5F5;" + |History of administration of large quantities of [[blood]] products that contain [[sodium citrate]]
-| align="left" style="background:#F5F5F5;" + |
-* Associated with [[Renal insufficiency|renal impairment]]
-|-
-! rowspan="5" align="center" style="background:#4479BA; color: #FFFFFF;" + |Drugs/Medication
-! align="center" style="background:#DCDCDC;" + |[[Diuretics|Chloruretic diuretics]]<ref name="LukeGalla2012">{{cite journal|last1=Luke|first1=R. G.|last2=Galla|first2=J. H.|title=It Is Chloride Depletion Alkalosis, Not Contraction Alkalosis|journal=Journal of the American Society of Nephrology|volume=23|issue=2|year=2012|pages=204–207|issn=1046-6673|doi=10.1681/ASN.2011070720}}</ref>
-! align="left" style="background:#DCDCDC;" + |
-* [[Bumetanide]]
-* [[Chlorothiazide]]
-* [[Metolazone]]
-| align="center" style="background:#F5F5F5;" + | +
-| align="center" style="background:#F5F5F5;" + |−
-| align="center" style="background:#F5F5F5;" + | +
-| align="center" style="background:#F5F5F5;" + | +
-| align="center" style="background:#F5F5F5;" + |−
-| align="center" style="background:#F5F5F5;" + |−
-| align="center" style="background:#F5F5F5;" + |−
-| align="center" style="background:#F5F5F5;" + |−
-| align="center" style="background:#F5F5F5;" + |↓
 | align="center" style="background:#F5F5F5;" + | +
 | align="center" style="background:#F5F5F5;" + |↑
@@ Line 199: / Line 117: @@
 | align="center" style="background:#F5F5F5;" + |↑
 | align="center" style="background:#F5F5F5;" + |Nl to ↑
-| align="center" style="background:#F5F5F5;" + |Nl to ↑
-| align="center" style="background:#F5F5F5;" + |↑
-| align="center" style="background:#F5F5F5;" + |History of diuretic use
-| align="left" style="background:#F5F5F5;" + |
-* [[Contraction alkalosis]]
-|-
-! colspan="2" align="center" style="background:#DCDCDC;" + |[[Penicillin]]<ref name="ZakiLad2011">{{cite journal|last1=Zaki|first1=SyedAhmed|last2=Lad|first2=Vijay|title=Piperacillin-tazobactam-induced hypokalemia and metabolic alkalosis|journal=Indian Journal of Pharmacology|volume=43|issue=5|year=2011|pages=609|issn=0253-7613|doi=10.4103/0253-7613.84986}}</ref>
-| align="center" style="background:#F5F5F5;" + |−
-| align="center" style="background:#F5F5F5;" + |−
-| align="center" style="background:#F5F5F5;" + |−
-| align="center" style="background:#F5F5F5;" + |−
-| align="center" style="background:#F5F5F5;" + |Nl
-| align="center" style="background:#F5F5F5;" + |−
-| align="center" style="background:#F5F5F5;" + |↑
-| align="center" style="background:#F5F5F5;" + |↑
 | align="center" style="background:#F5F5F5;" + |Nl
 | align="center" style="background:#F5F5F5;" + |↓
-| align="center" style="background:#F5F5F5;" + |↓
+| align="center" style="background:#F5F5F5;" + |Clinical  manifestations
-| align="center" style="background:#F5F5F5;" + |↑
-| align="center" style="background:#F5F5F5;" + |Nl
-| align="center" style="background:#F5F5F5;" + |↓
-| align="center" style="background:#F5F5F5;" + |↑
-| align="center" style="background:#F5F5F5;" + |Nl
-| align="center" style="background:#F5F5F5;" + |Nl
-| align="center" style="background:#F5F5F5;" + |Nl
-| align="center" style="background:#F5F5F5;" + |History of penicillin use
 | align="left" style="background:#F5F5F5;" + |
 * Not applicable
 |-
-! colspan="2" align="center" style="background:#DCDCDC;" + |Licorice<ref name="MeltemFigen2009">{{cite journal|last1=Meltem|first1=Akkas Camkurt|last2=Figen|first2=Coskun|last3=Nalan|first3=Metin Aksu|last4=Mahir|first4=Kunt|last5=Sebnem|first5=Bozkurt|last6=Mehlika|first6=Isildak|last7=Kasim|first7=Kilic Ahmet|last8=Miyase|first8=Bayraktar|title=A hypokalemic muscular weakness after licorice ingestion: a case report|journal=Cases Journal|volume=2|issue=1|year=2009|pages=8053|issn=1757-1626|doi=10.4076/1757-1626-2-8053}}</ref><ref name="LinYang2003">{{cite journal|last1=Lin|first1=Shih-Hua|last2=Yang|first2=Sung-Sen|last3=Chau|first3=Tom|last4=Halperin|first4=Mitchell L.|title=An Unusual Cause of Hypokalemic Paralysis: Chronic Licorice Ingestion|journal=The American Journal of the Medical Sciences|volume=325|issue=3|year=2003|pages=153–156|issn=00029629|doi=10.1097/00000441-200303000-00008}}</ref>
+! colspan="2" align="center" style="background:#DCDCDC;" + |Nasogastric tube suction<ref name="GilbertsonRogers2011">{{cite journal|last1=Gilbertson|first1=Heather Ruth|last2=Rogers|first2=Elizabeth Jessie|last3=Ukoumunne|first3=Obioha Chukwunyere|title=Determination of a Practical pH Cutoff Level for Reliable Confirmation of Nasogastric Tube Placement|journal=Journal of Parenteral and Enteral Nutrition|volume=35|issue=4|year=2011|pages=540–544|issn=0148-6071|doi=10.1177/0148607110383285}}</ref>
-| align="center" style="background:#F5F5F5;" + |−
-| align="center" style="background:#F5F5F5;" + |−
-| align="center" style="background:#F5F5F5;" + |−
 | align="center" style="background:#F5F5F5;" + | +
-| align="center" style="background:#F5F5F5;" + |Nl to ↑
-| align="center" style="background:#F5F5F5;" + |−
-| align="center" style="background:#F5F5F5;" + |↑
-| align="center" style="background:#F5F5F5;" + |↑
-| align="center" style="background:#F5F5F5;" + |Nl
-| align="center" style="background:#F5F5F5;" + |↓
-| align="center" style="background:#F5F5F5;" + |↓
-| align="center" style="background:#F5F5F5;" + |↑
-| align="center" style="background:#F5F5F5;" + |Nl
-| align="center" style="background:#F5F5F5;" + |Nl
-| align="center" style="background:#F5F5F5;" + |↑
-| align="center" style="background:#F5F5F5;" + |Nl to ↑
-| align="center" style="background:#F5F5F5;" + |Nl to ↑
-| align="center" style="background:#F5F5F5;" + |Nl
-| align="center" style="background:#F5F5F5;" + |Clinical  manifestations
-| align="left" style="background:#F5F5F5;" + |
-* [[Muscle weakness]]
-* [[Paralysis]]
-|-
-! colspan="2" align="center" style="background:#DCDCDC;" + |[[Laxative abuse]]<ref name="RoerigSteffen2010">{{cite journal|last1=Roerig|first1=James L.|last2=Steffen|first2=Kristine J.|last3=Mitchell|first3=James E.|last4=Zunker|first4=Christie|title=Laxative Abuse|journal=Drugs|volume=70|issue=12|year=2010|pages=1487–1503|issn=0012-6667|doi=10.2165/11898640-000000000-00000}}</ref>
-| align="center" style="background:#F5F5F5;" + | −
-| align="center" style="background:#F5F5F5;" + |−
-| align="center" style="background:#F5F5F5;" + |±
 | align="center" style="background:#F5F5F5;" + | +
-| align="center" style="background:#F5F5F5;" + |↓
 | align="center" style="background:#F5F5F5;" + | +
-| align="center" style="background:#F5F5F5;" + |↑
+| align="center" style="background:#F5F5F5;" + | -
-| align="center" style="background:#F5F5F5;" + |↑
-| align="center" style="background:#F5F5F5;" + |Nl
-| align="center" style="background:#F5F5F5;" + |↓
-| align="center" style="background:#F5F5F5;" + |↓
-| align="center" style="background:#F5F5F5;" + |↑
-| align="center" style="background:#F5F5F5;" + |Nl
-| align="center" style="background:#F5F5F5;" + |↑
-| align="center" style="background:#F5F5F5;" + |↑
-| align="center" style="background:#F5F5F5;" + |Nl to ↑
-| align="center" style="background:#F5F5F5;" + |Nl
-| align="center" style="background:#F5F5F5;" + |↓
-| align="center" style="background:#F5F5F5;" + |High level of suspicion
-| align="left" style="background:#F5F5F5;" + |
-* Large−volume, [[Diarrhea|watery diarrhea]]
-* Cramping [[abdominal pain]]
-* [[Weight loss]]
-|-
-! align="center" style="background:#DCDCDC;" + |[[Antacids]]<ref name="SahaniBrennan2001">{{cite journal|last1=Sahani|first1=Mandeep M.|last2=Brennan|first2=John F.|last3=Nwakanma|first3=Chukwuemeka|last4=Chow|first4=May T.|last5=Ing|first5=Todd S.|last6=Leehey|first6=David J.|title=Metabolic Alkalosis in a Hemodialysis Patient After Ingestion of a Large Amount of an Antacid Medication|journal=Artificial Organs|volume=25|issue=4|year=2001|pages=313–315|issn=0160-564X|doi=10.1046/j.1525-1594.2001.06714.x}}</ref><ref name="VanpeeDelgrange2000">{{cite journal|last1=Vanpee|first1=Dominique|last2=Delgrange|first2=Etienne|last3=Gillet|first3=Jean-Bernard|last4=Donckier|first4=Julian|title=Ingestion of antacid tablets (Rennie®) and acute confusion|journal=The Journal of Emergency Medicine|volume=19|issue=2|year=2000|pages=169–171|issn=07364679|doi=10.1016/S0736-4679(00)00206-7}}</ref>
-! align="left" style="background:#DCDCDC;" + |
-* Aluminum hydroxide
-* Sodium polystyrene sulfonate
-| align="center" style="background:#F5F5F5;" + | −
-| align="center" style="background:#F5F5F5;" + | −
-| align="center" style="background:#F5F5F5;" + | −
-| align="center" style="background:#F5F5F5;" + | −
-| align="center" style="background:#F5F5F5;" + |Nl
-| align="center" style="background:#F5F5F5;" + | −
-| align="center" style="background:#F5F5F5;" + |↑
-| align="center" style="background:#F5F5F5;" + |↑
-| align="center" style="background:#F5F5F5;" + |Nl
-| align="center" style="background:#F5F5F5;" + |↓
-| align="center" style="background:#F5F5F5;" + |↓
-| align="center" style="background:#F5F5F5;" + |↑
-| align="center" style="background:#F5F5F5;" + |Nl
-| align="center" style="background:#F5F5F5;" + |↑
-| align="center" style="background:#F5F5F5;" + |Nl
-| align="center" style="background:#F5F5F5;" + |Nl to ↑
-| align="center" style="background:#F5F5F5;" + |Nl to ↑
-| align="center" style="background:#F5F5F5;" + |Nl
-| align="center" style="background:#F5F5F5;" + |Clinical  manifestations
-| align="left" style="background:#F5F5F5;" + |
-* Not applicable
-|-
-! align="center" style="background:#4479BA; color: #FFFFFF;" + |Category
-! colspan="2" align="center" style="background:#4479BA; color: #FFFFFF;" + |Disease
-! align="center" style="background:#4479BA; color: #FFFFFF;" + |Hydrogen loss
-! align="center" style="background:#4479BA; color: #FFFFFF;" + |Accumulation of base
-! align="center" style="background:#4479BA; color: #FFFFFF;" + |Chloride depletion
-! align="center" style="background:#4479BA; color: #FFFFFF;" + |Mineralocorticoid excess
-! align="center" style="background:#4479BA; color: #FFFFFF;" + |Fever
-! align="center" style="background:#4479BA; color: #FFFFFF;" + |Dyspnea
-! align="center" style="background:#4479BA; color: #FFFFFF;" + |Edema
-! align="center" style="background:#4479BA; color: #FFFFFF;" + |Toxic/ill
-! align="center" style="background:#4479BA; color: #FFFFFF;" + |BP
-! align="center" style="background:#4479BA; color: #FFFFFF;" + |Dehydration
-! align="center" style="background:#4479BA; color: #FFFFFF;" + |HCO<sub>3</sub><sup>−</sup>
-! align="center" style="background:#4479BA; color: #FFFFFF;" + |paCO<sub>2</sub>
-! align="center" style="background:#4479BA; color: #FFFFFF;" + |O<sub>2</sub>
-! align="center" style="background:#4479BA; color: #FFFFFF;" + |Cl<sup>−</sup>
-! align="center" style="background:#4479BA; color: #FFFFFF;" + |K<sup>+</sup>
-! align="center" style="background:#4479BA; color: #FFFFFF;" + |Na<sup>+</sup>
-! align="center" style="background:#4479BA; color: #FFFFFF;" + |Ca<sup>+</sup>
-! align="center" style="background:#4479BA; color: #FFFFFF;" + |Mg<sup>+</sup>
-! align="center" style="background:#4479BA; color: #FFFFFF;" + |Renin
-! align="center" style="background:#4479BA; color: #FFFFFF;" + |Bun
-! align="center" style="background:#4479BA; color: #FFFFFF;" + |Cr
-! align="center" style="background:#4479BA; color: #FFFFFF;" + |Urine Cl<sup>−</sup>
-! align="center" style="background:#4479BA; color: #FFFFFF;" + |Gold standard diagnosis
-! align="center" style="background:#4479BA; color: #FFFFFF;" + |Other findings
-|-
-! rowspan="8" align="center" style="background:#4479BA; color: #FFFFFF;" + |Gastrointestinal origin
-! colspan="2" align="center" style="background:#DCDCDC;" + |[[Vomiting]]<ref name="GanMeyer2003">{{cite journal|last1=Gan|first1=Tong J.|last2=Meyer|first2=Tricia|last3=Apfel|first3=Christian C.|last4=Chung|first4=Frances|last5=Davis|first5=Peter J.|last6=Eubanks|first6=Steve|last7=Kovac|first7=Anthony|last8=Philip|first8=Beverly K.|last9=Sessler|first9=Daniel I.|last10=Temo|first10=James|last11=Tram??r|first11=Martin R.|last12=Watcha|first12=Mehernoor|title=Consensus Guidelines for Managing Postoperative Nausea and Vomiting|journal=Anesthesia & Analgesia|year=2003|pages=62–71|issn=0003-2999|doi=10.1213/01.ANE.0000068580.00245.95}}</ref>
-| align="center" style="background:#F5F5F5;" + |±
-| align="center" style="background:#F5F5F5;" + | −
-| align="center" style="background:#F5F5F5;" + | −
 | align="center" style="background:#F5F5F5;" + | +
-| align="center" style="background:#F5F5F5;" + |↓
-| align="center" style="background:#F5F5F5;" + | +
-| align="center" style="background:#F5F5F5;" + |↑
-| align="center" style="background:#F5F5F5;" + |↑
-| align="center" style="background:#F5F5F5;" + |Nl
-| align="center" style="background:#F5F5F5;" + |↓
-| align="center" style="background:#F5F5F5;" + |↓
-| align="center" style="background:#F5F5F5;" + |↑
-| align="center" style="background:#F5F5F5;" + |Nl
-| align="center" style="background:#F5F5F5;" + |Nl
-| align="center" style="background:#F5F5F5;" + |↑
-| align="center" style="background:#F5F5F5;" + |Nl to ↑
-| align="center" style="background:#F5F5F5;" + |Nl
-| align="center" style="background:#F5F5F5;" + |↓
-| align="center" style="background:#F5F5F5;" + |Clinical  manifestations
-| align="left" style="background:#F5F5F5;" + |
-* Not applicable
-|-
-! colspan="2" align="center" style="background:#DCDCDC;" + |Nasogastric tube suction<ref name="GilbertsonRogers2011">{{cite journal|last1=Gilbertson|first1=Heather Ruth|last2=Rogers|first2=Elizabeth Jessie|last3=Ukoumunne|first3=Obioha Chukwunyere|title=Determination of a Practical pH Cutoff Level for Reliable Confirmation of Nasogastric Tube Placement|journal=Journal of Parenteral and Enteral Nutrition|volume=35|issue=4|year=2011|pages=540–544|issn=0148-6071|doi=10.1177/0148607110383285}}</ref>
-| align="center" style="background:#F5F5F5;" + | −
-| align="center" style="background:#F5F5F5;" + | −
-| align="center" style="background:#F5F5F5;" + | −
-| align="center" style="background:#F5F5F5;" + | +
-| align="center" style="background:#F5F5F5;" + |↓
 | align="center" style="background:#F5F5F5;" + | +
 | align="center" style="background:#F5F5F5;" + |↑
@@ Line 379: / Line 147: @@
 * [[Pulmonary aspiration]]
 |-
-! colspan="2" align="center" style="background:#DCDCDC;" + |[[Zollinger-Ellison syndrome|Zollinger−Ellison syndrome]]<ref name="HungSchubert2003">{{cite journal|last1=Hung|first1=Patrick D.|last2=Schubert|first2=Mitchell L.|last3=Mihas|first3=Anastasios A.|title=Zollinger-Ellison syndrome|journal=Current Treatment Options in Gastroenterology|volume=6|issue=2|year=2003|pages=163–170|issn=1092-8472|doi=10.1007/s11938-003-0017-6}}</ref>
+! colspan="2" align="center" style="background:#DCDCDC;" + |Chronic [[laxative]] abuse
-| align="center" style="background:#F5F5F5;" + | −
+| align="center" style="background:#F5F5F5;" + | +
 | align="center" style="background:#F5F5F5;" + |−
 | align="center" style="background:#F5F5F5;" + |−
+| align="center" style="background:#F5F5F5;" + |-
 | align="center" style="background:#F5F5F5;" + | +
-| align="center" style="background:#F5F5F5;" + |↓
 | align="center" style="background:#F5F5F5;" + | +
 | align="center" style="background:#F5F5F5;" + |↑
@@ Line 391: / Line 159: @@
 | align="center" style="background:#F5F5F5;" + |↓
 | align="center" style="background:#F5F5F5;" + |↓
-| align="center" style="background:#F5F5F5;" + |↑
-| align="center" style="background:#F5F5F5;" + |Nl
-| align="center" style="background:#F5F5F5;" + |Nl
-| align="center" style="background:#F5F5F5;" + |↑
-| align="center" style="background:#F5F5F5;" + |Nl to ↑
-| align="center" style="background:#F5F5F5;" + |Nl
-| align="center" style="background:#F5F5F5;" + |↓
-| align="center" style="background:#F5F5F5;" + |Serum [[gastrin]] concentration + [[secretin]] stimulation test
-| align="left" style="background:#F5F5F5;" + |
-* Multiple or refractory [[Peptic ulcer|peptic ulcers]]
-* [[Chronic diarrhea]]
-* [[MEN1]]
-|-
-! colspan="2" align="center" style="background:#DCDCDC;" + |[[Bulimia nervosa]]<ref name="ShapiroBerkman2007">{{cite journal|last1=Shapiro|first1=Jennifer R.|last2=Berkman|first2=Nancy D.|last3=Brownley|first3=Kimberly A.|last4=Sedway|first4=Jan A.|last5=Lohr|first5=Kathleen N.|last6=Bulik|first6=Cynthia M.|title=Bulimia nervosa treatment: A systematic review of randomized controlled trials|journal=International Journal of Eating Disorders|volume=40|issue=4|year=2007|pages=321–336|issn=02763478|doi=10.1002/eat.20372}}</ref>
-| align="center" style="background:#F5F5F5;" + | −
-| align="center" style="background:#F5F5F5;" + |−
-| align="center" style="background:#F5F5F5;" + |±
-| align="center" style="background:#F5F5F5;" + | +
-| align="center" style="background:#F5F5F5;" + |↓
-| align="center" style="background:#F5F5F5;" + | +
-| align="center" style="background:#F5F5F5;" + |↑
-| align="center" style="background:#F5F5F5;" + |↑
-| align="center" style="background:#F5F5F5;" + |Nl
 | align="center" style="background:#F5F5F5;" + |↓
 | align="center" style="background:#F5F5F5;" + |↓
 | align="center" style="background:#F5F5F5;" + |↓
-| align="center" style="background:#F5F5F5;" + |Nl
 | align="center" style="background:#F5F5F5;" + |↓
-| align="center" style="background:#F5F5F5;" + |↑
 | align="center" style="background:#F5F5F5;" + |Nl to ↑
 | align="center" style="background:#F5F5F5;" + |Nl
 | align="center" style="background:#F5F5F5;" + |↓
-| align="center" style="background:#F5F5F5;" + |High level of suspicion
+| align="center" style="background:#F5F5F5;" + |Medication history
-| align="left" style="background:#F5F5F5;" + |
+| align="left" style="background:#F5F5F5;" + |Abdominal cramps, large volume [[diarrhea]]
-* [[Lethargy]]
-* Irregular [[Menstruation|menses]]
-* [[Abdominal pain]]
-* [[Constipation]]
-* [[Salivary gland]] hypertrophy
 |-
-! colspan="2" align="center" style="background:#DCDCDC;" + |Congenital chloridorrhea<ref name="WedenojaHãGlund2010">{{cite journal|last1=Wedenoja|first1=S.|last2=HãGlund|first2=P.|last3=Holmberg|first3=C.|title=Review article: the clinical management of congenital chloride diarrhoea|journal=Alimentary Pharmacology & Therapeutics|volume=31|issue=4|year=2010|pages=477–485|issn=02692813|doi=10.1111/j.1365-2036.2009.04197.x}}</ref>
+! colspan="2" align="center" style="background:#DCDCDC;" + |[[Villous adenoma]]<ref name="GennariWeise2008">{{cite journal|last1=Gennari|first1=F. J.|last2=Weise|first2=W. J.|title=Acid-Base Disturbances in Gastrointestinal Disease|journal=Clinical Journal of the American Society of Nephrology|volume=3|issue=6|year=2008|pages=1861–1868|issn=1555-9041|doi=10.2215/CJN.02450508}}</ref>
-| align="center" style="background:#F5F5F5;" + | −
-| align="center" style="background:#F5F5F5;" + | −
-| align="center" style="background:#F5F5F5;" + |±
 | align="center" style="background:#F5F5F5;" + | +
-| align="center" style="background:#F5F5F5;" + |↓
 | align="center" style="background:#F5F5F5;" + | +
-| align="center" style="background:#F5F5F5;" + |↑
-| align="center" style="background:#F5F5F5;" + |↑
-| align="center" style="background:#F5F5F5;" + |Nl
-| align="center" style="background:#F5F5F5;" + |↓
-| align="center" style="background:#F5F5F5;" + |↓
-| align="center" style="background:#F5F5F5;" + |↓
-| align="center" style="background:#F5F5F5;" + |↓
-| align="center" style="background:#F5F5F5;" + |↓
-| align="center" style="background:#F5F5F5;" + |↑
-| align="center" style="background:#F5F5F5;" + |Nl to ↑
-| align="center" style="background:#F5F5F5;" + |Nl to ↑
-| align="center" style="background:#F5F5F5;" + |Nl to ↑
-| align="center" style="background:#F5F5F5;" + |Clinical  manifestations+ lab findings
-| align="left" style="background:#F5F5F5;" + |
-* Profuse [[diarrhea]]
-* [[Polyhydramnios]]
-|-
-! colspan="2" align="center" style="background:#DCDCDC;" + |[[Pyloric stenosis]]<ref name="BakalSarac2016">{{cite journal|last1=Bakal|first1=Unal|last2=Sarac|first2=Mehmet|last3=Aydin|first3=Mustafa|last4=Tartar|first4=Tugay|last5=Kazez|first5=Ahmet|title=Recent changes in the features of hypertrophic pyloric stenosis|journal=Pediatrics International|volume=58|issue=5|year=2016|pages=369–371|issn=13288067|doi=10.1111/ped.12860}}</ref>
-| align="center" style="background:#F5F5F5;" + | −
-| align="center" style="background:#F5F5F5;" + |−
-| align="center" style="background:#F5F5F5;" + |−
 | align="center" style="background:#F5F5F5;" + | +
-| align="center" style="background:#F5F5F5;" + |↓
 | align="center" style="background:#F5F5F5;" + | +
-| align="center" style="background:#F5F5F5;" + |↑
-| align="center" style="background:#F5F5F5;" + |↑
-| align="center" style="background:#F5F5F5;" + |Nl
-| align="center" style="background:#F5F5F5;" + |↓
-| align="center" style="background:#F5F5F5;" + |↓
-| align="center" style="background:#F5F5F5;" + |↓ ↑
-| align="center" style="background:#F5F5F5;" + |Nl
-| align="center" style="background:#F5F5F5;" + |Nl
-| align="center" style="background:#F5F5F5;" + |↑
-| align="center" style="background:#F5F5F5;" + |Nl to ↑
-| align="center" style="background:#F5F5F5;" + |Nl
-| align="center" style="background:#F5F5F5;" + |↓
-| align="center" style="background:#F5F5F5;" + |Physical exam + imaging
-| align="left" style="background:#F5F5F5;" + |
-* Palpation of the “olive”
-|-
-! colspan="2" align="center" style="background:#DCDCDC;" + |[[Villous adenoma]]<ref name="GennariWeise2008">{{cite journal|last1=Gennari|first1=F. J.|last2=Weise|first2=W. J.|title=Acid-Base Disturbances in Gastrointestinal Disease|journal=Clinical Journal of the American Society of Nephrology|volume=3|issue=6|year=2008|pages=1861–1868|issn=1555-9041|doi=10.2215/CJN.02450508}}</ref>
-| align="center" style="background:#F5F5F5;" + | −
-| align="center" style="background:#F5F5F5;" + | −
-| align="center" style="background:#F5F5F5;" + | −
 | align="center" style="background:#F5F5F5;" + | +
-| align="center" style="background:#F5F5F5;" + |↓
 | align="center" style="background:#F5F5F5;" + | +
 | align="center" style="background:#F5F5F5;" + |↑
@@ Line 501: / Line 192: @@
 * [[Metabolic acidosis]]
 |-
-! colspan="2" align="center" style="background:#DCDCDC;" + |Gastrocystoplasty<ref name="KurzrockBaskin1998">{{cite journal|last1=Kurzrock|first1=Eric A.|last2=Baskin|first2=Laurence S.|last3=Kogan|first3=Barry A.|title=GASTROCYSTOPLASTY: LONG-TERM FOLLOWUP|journal=The Journal of Urology|volume=160|issue=6|year=1998|pages=2182–2186|issn=00225347|doi=10.1016/S0022-5347(01)62289-4}}</ref>
+! colspan="2" align="center" style="background:#DCDCDC;" + |[[Loop diuretics]]<ref name="pmid30623047">{{cite journal| author=Kataoka H| title=Dynamic changes in serum chloride concentrations during worsening of heart failure and its recovery following conventional diuretic therapy: A single-center study. | journal=Health Sci Rep | year= 2018 | volume= 1 | issue= 11 | pages= e94 | pmid=30623047 | doi=10.1002/hsr2.94 | pmc=6242367 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=30623047  }} </ref>
-| align="center" style="background:#F5F5F5;" + | −
+| align="center" style="background:#F5F5F5;" + |+
-| align="center" style="background:#F5F5F5;" + | −
+| align="center" style="background:#F5F5F5;" + |±
-| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + |-
-| align="center" style="background:#F5F5F5;" + | −
+| align="center" style="background:#F5F5F5;" + |-
-| align="center" style="background:#F5F5F5;" + |↓
+| align="center" style="background:#F5F5F5;" + |+
-| align="center" style="background:#F5F5F5;" + | −
+| align="center" style="background:#F5F5F5;" + |−
 | align="center" style="background:#F5F5F5;" + |↑
 | align="center" style="background:#F5F5F5;" + |↑
 | align="center" style="background:#F5F5F5;" + |Nl
 | align="center" style="background:#F5F5F5;" + |↓
-| align="center" style="background:#F5F5F5;" + |Nl
-| align="center" style="background:#F5F5F5;" + |Nl
-| align="center" style="background:#F5F5F5;" + |Nl
-| align="center" style="background:#F5F5F5;" + |Nl
-| align="center" style="background:#F5F5F5;" + |Nl
-| align="center" style="background:#F5F5F5;" + |Nl to ↑
-| align="center" style="background:#F5F5F5;" + |Nl to ↑
-| align="center" style="background:#F5F5F5;" + |Nl
-| align="center" style="background:#F5F5F5;" + |History of operation
-| align="left" style="background:#F5F5F5;" + |
-* [[Hematuria]]−[[dysuria]] syndrome
-|-
-! align="center" style="background:#4479BA; color: #FFFFFF;" + |Category
-! colspan="2" align="center" style="background:#4479BA; color: #FFFFFF;" + |Disease
-! align="center" style="background:#4479BA; color: #FFFFFF;" + |Fever
-! align="center" style="background:#4479BA; color: #FFFFFF;" + |Dyspnea
-! align="center" style="background:#4479BA; color: #FFFFFF;" + |Edema
-! align="center" style="background:#4479BA; color: #FFFFFF;" + |Toxic/ill
-! align="center" style="background:#4479BA; color: #FFFFFF;" + |BP
-! align="center" style="background:#4479BA; color: #FFFFFF;" + |Dehydration
-! align="center" style="background:#4479BA; color: #FFFFFF;" + |HCO<sub>3</sub><sup>−</sup>
-! align="center" style="background:#4479BA; color: #FFFFFF;" + |paCO<sub>2</sub>
-! align="center" style="background:#4479BA; color: #FFFFFF;" + |O<sub>2</sub>
-! align="center" style="background:#4479BA; color: #FFFFFF;" + |Cl<sup>−</sup>
-! align="center" style="background:#4479BA; color: #FFFFFF;" + |K<sup>+</sup>
-! align="center" style="background:#4479BA; color: #FFFFFF;" + |Na<sup>+</sup>
-! align="center" style="background:#4479BA; color: #FFFFFF;" + |Ca<sup>+</sup>
-! align="center" style="background:#4479BA; color: #FFFFFF;" + |Mg<sup>+</sup>
-! align="center" style="background:#4479BA; color: #FFFFFF;" + |Renin
-! align="center" style="background:#4479BA; color: #FFFFFF;" + |Bun
-! align="center" style="background:#4479BA; color: #FFFFFF;" + |Cr
-! align="center" style="background:#4479BA; color: #FFFFFF;" + |Urine Cl<sup>−</sup>
-! align="center" style="background:#4479BA; color: #FFFFFF;" + |Gold standard diagnosis
-! align="center" style="background:#4479BA; color: #FFFFFF;" + |Other findings
-|-
-! rowspan="8" align="center" style="background:#4479BA; color: #FFFFFF;" + |Renal origin
-! colspan="2" align="center" style="background:#DCDCDC;" + |Posthypercapnic state<ref name="BangaKhilnani2009">{{cite journal|last1=Banga|first1=Amit|last2=Khilnani|first2=G. C.|title=Post-hypercapnic Alkalosis is Associated with Ventilator Dependence and Increased ICU stay|journal=COPD: Journal of Chronic Obstructive Pulmonary Disease|volume=6|issue=6|year=2009|pages=437–440|issn=1541-2555|doi=10.3109/15412550903341448}}</ref>
-| align="center" style="background:#F5F5F5;" + | −
-| align="center" style="background:#F5F5F5;" + |±
-| align="center" style="background:#F5F5F5;" + | −
-| align="center" style="background:#F5F5F5;" + | −
-| align="center" style="background:#F5F5F5;" + |Nl
-| align="center" style="background:#F5F5F5;" + |−
-| align="center" style="background:#F5F5F5;" + |↑
-| align="center" style="background:#F5F5F5;" + |↑↑
 | align="center" style="background:#F5F5F5;" + |↓
 | align="center" style="background:#F5F5F5;" + |↓
 | align="center" style="background:#F5F5F5;" + |↓
-| align="center" style="background:#F5F5F5;" + |↑
+| align="center" style="background:#F5F5F5;" + |↓
-| align="center" style="background:#F5F5F5;" + |Nl
-| align="center" style="background:#F5F5F5;" + |Nl
-| align="center" style="background:#F5F5F5;" + |↑
-| align="center" style="background:#F5F5F5;" + |Nl
-| align="center" style="background:#F5F5F5;" + |Nl
-| align="center" style="background:#F5F5F5;" + |Nl
-| align="center" style="background:#F5F5F5;" + |Lab findings
-| align="left" style="background:#F5F5F5;" + |
-* Chronic [[respiratory acidosis]]
-|-
-! colspan="2" align="center" style="background:#DCDCDC;" + |[[Hypomagnesemia]]<ref name="pmid9252977">{{cite journal |vauthors=Elisaf M, Milionis H, Siamopoulos KC |title=Hypomagnesemic hypokalemia and hypocalcemia: clinical and laboratory characteristics |journal=Miner Electrolyte Metab |volume=23 |issue=2 |pages=105–12 |date=1997 |pmid=9252977 |doi= |url=}}</ref>
-| align="center" style="background:#F5F5F5;" + |−
-| align="center" style="background:#F5F5F5;" + |−
-| align="center" style="background:#F5F5F5;" + |−
-| align="center" style="background:#F5F5F5;" + |−
-| align="center" style="background:#F5F5F5;" + |Nl
-| align="center" style="background:#F5F5F5;" + |−
 | align="center" style="background:#F5F5F5;" + |↑
 | align="center" style="background:#F5F5F5;" + |↑
-| align="center" style="background:#F5F5F5;" + |Nl
-| align="center" style="background:#F5F5F5;" + |↓
-| align="center" style="background:#F5F5F5;" + |↓
 | align="center" style="background:#F5F5F5;" + |↑
-| align="center" style="background:#F5F5F5;" + |Nl
-| align="center" style="background:#F5F5F5;" + |Nl
 | align="center" style="background:#F5F5F5;" + |↑
-| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + |Medication history
-| align="center" style="background:#F5F5F5;" + |Nl
+| align="left" style="background:#F5F5F5;" + |Not applicable
-| align="center" style="background:#F5F5F5;" + |Nl
-| align="center" style="background:#F5F5F5;" + |Lab findings
-| align="left" style="background:#F5F5F5;" + |
-* Not applicable
 |-
-! colspan="2" align="center" style="background:#DCDCDC;" + |[[Hypokalemia]]<ref name="pmid10665945">{{cite journal |vauthors=Galla JH |title=Metabolic alkalosis |journal=J. Am. Soc. Nephrol. |volume=11 |issue=2 |pages=369–75 |date=February 2000 |pmid=10665945 |doi= |url=}}</ref>
+! colspan="2" align="center" style="background:#DCDCDC;" + |[[Thiazide diuretics]]
-| align="center" style="background:#F5F5F5;" + |−
+| align="center" style="background:#F5F5F5;" + |+
-| align="center" style="background:#F5F5F5;" + |−
+| align="center" style="background:#F5F5F5;" + |±
-| align="center" style="background:#F5F5F5;" + |−
+| align="center" style="background:#F5F5F5;" + |-
-| align="center" style="background:#F5F5F5;" + |−
+| align="center" style="background:#F5F5F5;" + |-
-| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + |+
 | align="center" style="background:#F5F5F5;" + |−
 | align="center" style="background:#F5F5F5;" + |↑
 | align="center" style="background:#F5F5F5;" + |↑
 | align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + |↓
 | align="center" style="background:#F5F5F5;" + |↓
 | align="center" style="background:#F5F5F5;" + |↓
 | align="center" style="background:#F5F5F5;" + |↑
-| align="center" style="background:#F5F5F5;" + |Nl
-| align="center" style="background:#F5F5F5;" + |Nl
-| align="center" style="background:#F5F5F5;" + |↑
-| align="center" style="background:#F5F5F5;" + |Nl
-| align="center" style="background:#F5F5F5;" + |Nl
-| align="center" style="background:#F5F5F5;" + |Nl
-| align="center" style="background:#F5F5F5;" + |Lab findings
-| align="left" style="background:#F5F5F5;" + |
-* Not applicable
-|-
-! colspan="2" align="center" style="background:#DCDCDC;" + |[[Bartter's syndrome]]<ref name="SimonKaret1996">{{cite journal|last1=Simon|first1=David B.|last2=Karet|first2=Fiona E.|last3=Hamdan|first3=Jahed M.|last4=Pietro|first4=Antonio Di|last5=Sanjad|first5=Sami A.|last6=Lifton|first6=Richard P.|title=Bartter's syndrome, hypokalaemic alkalosis with hypercalciuria, is caused by mutations in the Na–K–2CI cotransporter NKCC2|journal=Nature Genetics|volume=13|issue=2|year=1996|pages=183–188|issn=1061-4036|doi=10.1038/ng0696-183}}</ref>
-| align="center" style="background:#F5F5F5;" + | −
-| align="center" style="background:#F5F5F5;" + | −
-| align="center" style="background:#F5F5F5;" + | −
-| align="center" style="background:#F5F5F5;" + | −
-| align="center" style="background:#F5F5F5;" + |Nl
-| align="center" style="background:#F5F5F5;" + | +
-| align="center" style="background:#F5F5F5;" + |↑
-| align="center" style="background:#F5F5F5;" + |↑
-| align="center" style="background:#F5F5F5;" + |Nl
-| align="center" style="background:#F5F5F5;" + |↓
-| align="center" style="background:#F5F5F5;" + |↓↓
-| align="center" style="background:#F5F5F5;" + |↓
 | align="center" style="background:#F5F5F5;" + |↓
-| align="center" style="background:#F5F5F5;" + |Nl
 | align="center" style="background:#F5F5F5;" + |↑
-| align="center" style="background:#F5F5F5;" + |Nl to ↑
-| align="center" style="background:#F5F5F5;" + |Nl to ↑
-| align="center" style="background:#F5F5F5;" + |Nl
-| align="center" style="background:#F5F5F5;" + |Genetic testing
-| align="left" style="background:#F5F5F5;" + |
-* [[Constipation]]
-* [[Cramp|Muscle cramps]] and [[Muscle weakness|weakness]]
-* [[Failure to thrive]]
-* [[Sensorineural hearing loss|Sensorineural deafness]]
-* [[Focal segmental glomerulosclerosis]]
-* [[Hypercalciuria]]
-|-
-! colspan="2" align="center" style="background:#DCDCDC;" + |[[Gitelman syndrome|Gitelman’s syndrome]]<ref name="FremontChan2012">{{cite journal|last1=Fremont|first1=Oliver T.|last2=Chan|first2=James C. M.|title=Understanding Bartter syndrome and Gitelman syndrome|journal=World Journal of Pediatrics|volume=8|issue=1|year=2012|pages=25–30|issn=1708-8569|doi=10.1007/s12519-012-0333-9}}</ref><ref name="pmid7700218">{{cite journal |vauthors=Colussi G, Macaluso M, Brunati C, Minetti L |title=Calcium metabolism and calciotropic hormone levels in Gitelman's syndrome |journal=Miner Electrolyte Metab |volume=20 |issue=5 |pages=294–301 |date=1994 |pmid=7700218 |doi= |url=}}</ref>
-| align="center" style="background:#F5F5F5;" + | −
-| align="center" style="background:#F5F5F5;" + | −
-| align="center" style="background:#F5F5F5;" + | −
-| align="center" style="background:#F5F5F5;" + | −
-| align="center" style="background:#F5F5F5;" + |↓
-| align="center" style="background:#F5F5F5;" + | +
 | align="center" style="background:#F5F5F5;" + |↑
 | align="center" style="background:#F5F5F5;" + |↑
-| align="center" style="background:#F5F5F5;" + |Nl
-| align="center" style="background:#F5F5F5;" + |↓
-| align="center" style="background:#F5F5F5;" + |↓↓
-| align="center" style="background:#F5F5F5;" + |↓
-| align="center" style="background:#F5F5F5;" + |Nl
-| align="center" style="background:#F5F5F5;" + |↓
 | align="center" style="background:#F5F5F5;" + |↑
-| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + |Medication history
-| align="center" style="background:#F5F5F5;" + |Nl
+| align="left" style="background:#F5F5F5;" + |Not applicable
-| align="center" style="background:#F5F5F5;" + |Nl
-| align="center" style="background:#F5F5F5;" + |Genetic testing
-| align="left" style="background:#F5F5F5;" + |
-* Less severe
-* [[Constipation]]
-* [[Cramp|Muscle cramps]] and [[Muscle weakness|weakness]]
-* [[Hypocalciuria]]
 |-
 ! colspan="2" align="center" style="background:#DCDCDC;" + |[[Renal artery stenosis]]<ref name="SafianTextor2001">{{cite journal|last1=Safian|first1=Robert D.|last2=Textor|first2=Stephen C.|title=Renal-Artery Stenosis|journal=New England Journal of Medicine|volume=344|issue=6|year=2001|pages=431–442|issn=0028-4793|doi=10.1056/NEJM200102083440607}}</ref>
@@ Line 718: / Line 283: @@
 * Not applicable
 |-
-! colspan="2" align="center" style="background:#DCDCDC;" + |[[Renal cell carcinoma|Renal tumors]]<ref name="LasseigneBrooks2018">{{cite journal|last1=Lasseigne|first1=Brittany N.|last2=Brooks|first2=James D.|title=The Role of DNA Methylation in Renal Cell Carcinoma|journal=Molecular Diagnosis & Therapy|year=2018|issn=1177-1062|doi=10.1007/s40291-018-0337-9}}</ref>
-| align="center" style="background:#F5F5F5;" + | −
-| align="center" style="background:#F5F5F5;" + | +
-| align="center" style="background:#F5F5F5;" + | +
-| align="center" style="background:#F5F5F5;" + | +
-| align="center" style="background:#F5F5F5;" + |↑
-| align="center" style="background:#F5F5F5;" + | +
-| align="center" style="background:#F5F5F5;" + |↑
-| align="center" style="background:#F5F5F5;" + |↑
-| align="center" style="background:#F5F5F5;" + |↓
-| align="center" style="background:#F5F5F5;" + |↓
-| align="center" style="background:#F5F5F5;" + |↑
-| align="center" style="background:#F5F5F5;" + |↓
-| align="center" style="background:#F5F5F5;" + |↑
-| align="center" style="background:#F5F5F5;" + |Nl
-| align="center" style="background:#F5F5F5;" + |↑
-| align="center" style="background:#F5F5F5;" + |↑
-| align="center" style="background:#F5F5F5;" + |↑
-| align="center" style="background:#F5F5F5;" + |Nl
-| align="center" style="background:#F5F5F5;" + |[[Biopsy]]
-| align="left" style="background:#F5F5F5;" + |
-* Not applicable
-|-
-! rowspan="5" align="center" style="background:#4479BA; color: #FFFFFF;" + |Endocrine
 ! colspan="2" align="center" style="background:#DCDCDC;" + |[[Cushing's syndrome]]<ref name="Araujo CastroMarazuela Azpiroz2018">{{cite journal|last1=Araujo Castro|first1=Marta|last2=Marazuela Azpiroz|first2=Mónica|title=Two types of ectopic Cushing syndrome or a continuum? Review|journal=Pituitary|year=2018|issn=1386-341X|doi=10.1007/s11102-018-0894-2}}</ref>
 | align="center" style="background:#F5F5F5;" + | −
@@ Line 768: / Line 309: @@
 * [[Menstrual cycle|Menstrual]] changes
 |-
-! rowspan="2" align="center" style="background:#DCDCDC;" + |[[Hyperaldosteronism]]
+! colspan="2" align="center" style="background:#DCDCDC;" + |[[Primary hyperaldosteronism]]<ref name="Martell-ClarosAbad-Cardiel2015">{{cite journal|last1=Martell-Claros|first1=Nieves|last2=Abad-Cardiel|first2=María|last3=Alvarez-Alvarez|first3=Beatriz|last4=García-Donaire|first4=José A.|last5=Pérez|first5=Cristina Fernández|title=Primary aldosteronism and its various clinical scenarios|journal=Journal of Hypertension|volume=33|issue=6|year=2015|pages=1226–1232|issn=0263-6352|doi=10.1097/HJH.0000000000000546}}</ref>
-! align="center" style="background:#DCDCDC;" + |[[Primary hyperaldosteronism|Primary]]<ref name="Martell-ClarosAbad-Cardiel2015">{{cite journal|last1=Martell-Claros|first1=Nieves|last2=Abad-Cardiel|first2=María|last3=Alvarez-Alvarez|first3=Beatriz|last4=García-Donaire|first4=José A.|last5=Pérez|first5=Cristina Fernández|title=Primary aldosteronism and its various clinical scenarios|journal=Journal of Hypertension|volume=33|issue=6|year=2015|pages=1226–1232|issn=0263-6352|doi=10.1097/HJH.0000000000000546}}</ref>
 | align="center" style="background:#F5F5F5;" + | −
 | align="center" style="background:#F5F5F5;" + | −
@@ Line 794: / Line 334: @@
 * Bilateral [[adrenal hyperplasia]]
 |-
-! align="center" style="background:#DCDCDC;" + |[[Secondary hyperaldosteronism|Secondary]]<ref name="pmid29758100">{{cite journal |vauthors=Monticone S, Losano I, Tetti M, Buffolo F, Veglio F, Mulatero P |title=Diagnostic approach to low renin hypertension |journal=Clin. Endocrinol. (Oxf) |volume= |issue= |pages= |date=May 2018 |pmid=29758100 |doi=10.1111/cen.13741 |url=}}</ref>
-| align="center" style="background:#F5F5F5;" + | −
-| align="center" style="background:#F5F5F5;" + | +
-| align="center" style="background:#F5F5F5;" + | +
-| align="center" style="background:#F5F5F5;" + | +
-| align="center" style="background:#F5F5F5;" + |↑
-| align="center" style="background:#F5F5F5;" + | +
-| align="center" style="background:#F5F5F5;" + |↑
-| align="center" style="background:#F5F5F5;" + |↑
-| align="center" style="background:#F5F5F5;" + |Nl
-| align="center" style="background:#F5F5F5;" + |↓
-| align="center" style="background:#F5F5F5;" + |↓
-| align="center" style="background:#F5F5F5;" + |↑
-| align="center" style="background:#F5F5F5;" + |Nl
-| align="center" style="background:#F5F5F5;" + |↓
-| align="center" style="background:#F5F5F5;" + |↑
-| align="center" style="background:#F5F5F5;" + |↑
-| align="center" style="background:#F5F5F5;" + |↑
-| align="center" style="background:#F5F5F5;" + |Nl
-| align="center" style="background:#F5F5F5;" + |Lab findings
-| align="left" style="background:#F5F5F5;" + |
-* [[Renin-producing tumors|Renin−producing tumor]]
-* [[Renal artery stenosis]]
-* Left ventricular [[Congestive heart failure|heart failure]]
-* [[Right heart failure|Cor pulmonale]]
-* [[Cirrhosis]] with [[ascites]]
-|-
-! rowspan="2" align="center" style="background:#DCDCDC;" + |[[Congenital adrenal hyperplasia]]
-! align="center" style="background:#DCDCDC;" + |[[11β-hydroxylase deficiency|11β−Hydroxylase deficiency]]<ref name="pmid29626607">{{cite journal |vauthors=Baş F, Toksoy G, Ergun-Longmire B, Uyguner ZO, Abalı ZY, Poyrazoğlu Ş, Karaman V, Avcı Ş, Altunoğlu U, Bundak R, Karaman B, Başaran S, Darendeliler F |title=Prevalence, clinical characteristics and long-term outcomes of classical 11 β-hydroxylase deficiency (11BOHD) in Turkish population and novel mutations in CYP11B1 gene |journal=J. Steroid Biochem. Mol. Biol. |volume= |issue= |pages= |date=April 2018 |pmid=29626607 |doi=10.1016/j.jsbmb.2018.04.001 |url=}}</ref>
-| align="center" style="background:#F5F5F5;" + | −
-| align="center" style="background:#F5F5F5;" + | −
-| align="center" style="background:#F5F5F5;" + | +
-| align="center" style="background:#F5F5F5;" + | −
-| align="center" style="background:#F5F5F5;" + |↑
-| align="center" style="background:#F5F5F5;" + | +
-| align="center" style="background:#F5F5F5;" + |↑
-| align="center" style="background:#F5F5F5;" + |↑
-| align="center" style="background:#F5F5F5;" + |Nl
-| align="center" style="background:#F5F5F5;" + |↓
-| align="center" style="background:#F5F5F5;" + |↓
-| align="center" style="background:#F5F5F5;" + |↓
-| align="center" style="background:#F5F5F5;" + |↑
-| align="center" style="background:#F5F5F5;" + |Nl
-| align="center" style="background:#F5F5F5;" + |↓
-| align="center" style="background:#F5F5F5;" + |Nl
-| align="center" style="background:#F5F5F5;" + |Nl
-| align="center" style="background:#F5F5F5;" + |Nl
-| align="center" style="background:#F5F5F5;" + |Genetic testing
-| align="left" style="background:#F5F5F5;" + |
-* [[Virilization]]
-* [[Hyperpigmentation|Skin hyperpigmentation]]
-* Bilateral [[adrenal gland]] enlargement
-|-
-! align="center" style="background:#DCDCDC;" + |[[17 alpha-hydroxylase deficiency|17α−Hydroxylase deficiency]]<ref name="GoldsmithSolomon1967">{{cite journal|last1=Goldsmith|first1=Oliver|last2=Solomon|first2=David H.|last3=Horton|first3=Richard|title=Hypogonadism and Mineralocorticoid Excess|journal=New England Journal of Medicine|volume=277|issue=13|year=1967|pages=673–677|issn=0028-4793|doi=10.1056/NEJM196709282771302}}</ref>
-| align="center" style="background:#F5F5F5;" + | −
-| align="center" style="background:#F5F5F5;" + | −
-| align="center" style="background:#F5F5F5;" + | +
-| align="center" style="background:#F5F5F5;" + | −
-| align="center" style="background:#F5F5F5;" + |↑
-| align="center" style="background:#F5F5F5;" + | +
-| align="center" style="background:#F5F5F5;" + |↑
-| align="center" style="background:#F5F5F5;" + |↑
-| align="center" style="background:#F5F5F5;" + |Nl
-| align="center" style="background:#F5F5F5;" + |↓
-| align="center" style="background:#F5F5F5;" + |↓
-| align="center" style="background:#F5F5F5;" + |↓
-| align="center" style="background:#F5F5F5;" + |↑
-| align="center" style="background:#F5F5F5;" + |Nl
-| align="center" style="background:#F5F5F5;" + |↓
-| align="center" style="background:#F5F5F5;" + |Nl
-| align="center" style="background:#F5F5F5;" + |Nl
-| align="center" style="background:#F5F5F5;" + |Nl
-| align="center" style="background:#F5F5F5;" + |Genetic testing
-| align="left" style="background:#F5F5F5;" + |
-* [[Intersexuality|Ambiguous genitalia]]
-* [[Undescended testes]]
-* Lacks [[Secondary sexual characteristic|2° sexual development]]
-* [[Hyperpigmentation|Skin hyperpigmentation]]
-* Bilateral [[adrenal gland]] enlargement
-|-
-! align="center" style="background:#4479BA; color: #FFFFFF;" + |Systemic
 ! colspan="2" align="center" style="background:#DCDCDC;" + |[[Cystic fibrosis]]<ref name="pmid9048354">{{cite journal |vauthors=Bates CM, Baum M, Quigley R |title=Cystic fibrosis presenting with hypokalemia and metabolic alkalosis in a previously healthy adolescent |journal=J. Am. Soc. Nephrol. |volume=8 |issue=2 |pages=352–5 |date=February 1997 |pmid=9048354 |doi= |url=}}</ref>
 | align="center" style="background:#F5F5F5;" + |−
@@ Line 899: / Line 358: @@
 * Persistent pulmonary [[infection]]
 * [[Pancreatic insufficiency]]
+|}
+'''''Differential diagnosis of respiratory alkalosis is as follow''''':
+{|
+! colspan="2" rowspan="4" align="center" style="background:#4479BA; color: #FFFFFF;" + |Disease
+! colspan="6" align="center" style="background:#4479BA; color: #FFFFFF;" + |Clinical
+! colspan="12" align="center" style="background:#4479BA; color: #FFFFFF;" + |Paraclinical
+! rowspan="4" align="center" style="background:#4479BA; color: #FFFFFF;" + |Gold standard diagnosis
+! rowspan="4" align="center" style="background:#4479BA; color: #FFFFFF;" + |Other findings
+|-
+! colspan="3" rowspan="2" align="center" style="background:#4479BA; color: #FFFFFF;" + |Symptoms
+! colspan="3" rowspan="2" align="center" style="background:#4479BA; color: #FFFFFF;" + |Signs
+|-
+! colspan="3" align="center" style="background:#4479BA; color: #FFFFFF;" + |ABG
+! colspan="5" align="center" style="background:#4479BA; color: #FFFFFF;" + |CBC
+! align="center" style="background:#4479BA; color: #FFFFFF;" + |Imaging
+! colspan="3" align="center" style="background:#4479BA; color: #FFFFFF;" + |PFTs
 |-
-! align="center" style="background:#4479BA; color: #FFFFFF;" + |Category
+! align="center" style="background:#4479BA; color: #FFFFFF;" + |Dyspnea on exertion
-! colspan="2" align="center" style="background:#4479BA; color: #FFFFFF;" + |Disease
+! align="center" style="background:#4479BA; color: #FFFFFF;" + |Orthopnea
-! align="center" style="background:#4479BA; color: #FFFFFF;" + |Fever
+! align="center" style="background:#4479BA; color: #FFFFFF;" + |Cough
-! align="center" style="background:#4479BA; color: #FFFFFF;" + |Dyspnea
+! align="center" style="background:#4479BA; color: #FFFFFF;" + |Chest pain
-! align="center" style="background:#4479BA; color: #FFFFFF;" + |Edema
+! align="center" style="background:#4479BA; color: #FFFFFF;" + |Agitation
-! align="center" style="background:#4479BA; color: #FFFFFF;" + |Toxic/ill
+! align="center" style="background:#4479BA; color: #FFFFFF;" + |loss of consciousness
-! align="center" style="background:#4479BA; color: #FFFFFF;" + |BP
-! align="center" style="background:#4479BA; color: #FFFFFF;" + |Dehydration
-! align="center" style="background:#4479BA; color: #FFFFFF;" + |HCO<sub>3</sub><sup>−</sup>
-! align="center" style="background:#4479BA; color: #FFFFFF;" + |paCO<sub>2</sub>
-! align="center" style="background:#4479BA; color: #FFFFFF;" + |O<sub>2</sub>
-! align="center" style="background:#4479BA; color: #FFFFFF;" + |Cl<sup>−</sup>
-! align="center" style="background:#4479BA; color: #FFFFFF;" + |K<sup>+</sup>
-! align="center" style="background:#4479BA; color: #FFFFFF;" + |Na<sup>+</sup>
-! align="center" style="background:#4479BA; color: #FFFFFF;" + |Ca<sup>+</sup>
-! align="center" style="background:#4479BA; color: #FFFFFF;" + |Mg<sup>+</sup>
-! align="center" style="background:#4479BA; color: #FFFFFF;" + |Renin
-! align="center" style="background:#4479BA; color: #FFFFFF;" + |Bun
-! align="center" style="background:#4479BA; color: #FFFFFF;" + |Cr
-! align="center" style="background:#4479BA; color: #FFFFFF;" + |Urine Cl<sup>−</sup>
-! align="center" style="background:#4479BA; color: #FFFFFF;" + |Gold standard diagnosis
-! align="center" style="background:#4479BA; color: #FFFFFF;" + |Other findings
-|}
 ==References ==

Alkalosis: Difference between revisions

Latest revision as of 14:55, 13 October 2020

Overview

Classification

Causes

Common Causes

Causes in Alphabetical Order

Metabolic Alkalosis

Pathophysiology

Metabolic Alkalosis

Shift of hydrogen ions intracellularly

Reduced Blood volume

Loss of Gastric acid

Extracellular volume expansion

Respiratory Alkalosis

Epidemiology and Demographics

Differential Diagnosis

References

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