Sandbox: wdx causes: Difference between revisions
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* [[Weight loss]] | * [[Weight loss]] | ||
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! 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> | ! 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> | ||
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* Aluminum hydroxide | * Aluminum hydroxide | ||
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! rowspan="8" align="center" style="background:#4479BA; color: #FFFFFF;" + |Gastrointestinal origin | ! rowspan="8" align="center" style="background:#4479BA; color: #FFFFFF;" + |Gastrointestinal origin | ||
! colspan="2" align="center" style="background:#DCDCDC;" + |Vomiting | ! 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> | ||
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! colspan="2" align="center" style="background:#DCDCDC;" + |Nasogastric tube suction | ! 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;" + | + | ||
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| align="center" style="background:#F5F5F5;" + |Clinical | | align="center" style="background:#F5F5F5;" + |Clinical | ||
| align="left" style="background:#F5F5F5;" + | | | align="left" style="background:#F5F5F5;" + | | ||
* [[Gastroesophageal reflux disease|GERD]] | |||
|- | |- | ||
! colspan="2" align="center" style="background:#DCDCDC;" + |Zollinger−Ellison syndrome | ! colspan="2" align="center" style="background:#DCDCDC;" + |Zollinger−Ellison syndrome |
Revision as of 17:59, 18 May 2018
Metabolic Alkalosis
Differential diagnosis of metabolic alkalosis is as follow:[1]
Category | Disease | Mechanism | Clinical | Paraclinical | Gold standard diagnosis | Other findings | ||||||||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Symptoms | Signs | Lab data | ||||||||||||||||||||||||
ABG | Chemistry | Enzyme | Renal function | |||||||||||||||||||||||
Hydrogen loss | Accumulation of base | Chloride depletion | Mineralocorticoid excess | Fever | Dyspnea | Edema | Toxic/ill | BP | Dehydration | HCO3− | paCO2 | O2 | Cl− | K+ | Na+ | Ca+ | Mg+ | Renin | Bun | Cr | Urine Cl− | |||||
Exogenous HCO3− loads | Acute alkali administration[2] | − | + | − | − | − | + | − | + | ↓ | − | ↑ | ↑ | ↓ | ↓ | ↓ | ↓ | ↑ | Nl | Nl | ↑ | ↑ | Nl | Clinical |
| |
Milk−alkali syndrome[3] | − | + | − | + | − | + | − | + | ↓ | + | ↑ | ↑ | ↓ | ↓ | ↓ | ↓ | ↑ | ↓ | ↑ | ↑ | ↑ | Nl | Clinical + exclusion of other causes of hypercalcemia |
| ||
Transfusion[4] | − | + | − | − | ± | ± | − | + | ↓ | − | ↑ | ↑ | ↓ | ↓ | ↓ ↑ | ↓ | ↓ | ↑ | ↑ | Nl to ↑ | Nl to ↑ | Nl | History of administration of large quantities of blood products that contain sodium citrate |
| ||
Drugs/Medication | Chloruretic diuretics[5] |
|
+ | − | + | + | − | − | − | − | ↓ | + | ↑ | ↑ | Nl | ↓ | ↓ | ↑ | Nl | Nl | ↑ | Nl to ↑ | Nl to ↑ | ↑ | History | |
Penicillin[6] | + | − | − | − | − | − | − | − | Nl | − | ↑ | ↑ | Nl | ↓ | ↓ | ↑ | Nl | ↓ | ↑ | Nl | Nl | Nl | History | |||
Licorice[7][8] | + | − | − | + | − | − | − | + | Nl to ↑ | − | ↑ | ↑ | Nl | ↓ | ↓ | ↑ | Nl | Nl | ↑ | Nl to ↑ | Nl to ↑ | Nl | Clinical | |||
Laxative abuse[9] | + | − | + | − | - | − | ± | + | ↓ | + | ↑ | ↑ | Nl | ↓ | ↓ | ↑ | Nl | ↑ | ↑ | Nl to ↑ | Nl | ↓ | High level of suspicion |
| ||
Antacids[10][11] |
|
+ | + | − | − | − | − | − | − | Nl | − | ↑ | ↑ | Nl | ↓ | ↓ | ↑ | Nl | ↑ | Nl | Nl to ↑ | Nl to ↑ | Nl | Clinical | ||
Category | Disease | Hydrogen loss | Accumulation of base | Chloride depletion | Mineralocorticoid excess | Fever | Dyspnea | Edema | Toxic/ill | BP | Dehydration | HCO3− | paCO2 | O2 | Cl− | K+ | Na+ | Ca+ | Mg+ | Renin | Bun | Cr | Urine Cl− | Gold standard diagnosis | Other findings | |
Gastrointestinal origin | Vomiting[12] | + | − | + | − | ± | − | − | + | ↓ | + | ↑ | ↑ | Nl | ↓ | ↓ | ↑ | Nl | Nl | ↑ | Nl to ↑ | Nl | ↓ | Clinical | ||
Nasogastric tube suction[13] | + | − | + | − | − | − | − | + | ↓ | + | ↑ | ↑ | Nl | ↓ | ↓ | ↑ | Nl | Nl | ↑ | Nl to ↑ | Nl | ↓ | Clinical | |||
Zollinger−Ellison syndrome | ||||||||||||||||||||||||||
Bulimia nervosa[14] | + | − | + | − | - | − | ± | + | ↓ | + | ↑ | ↑ | Nl | ↓ | ↓ | ↓ | Nl | ↓ | ↑ | Nl to ↑ | Nl | ↓ | High level of suspicion |
| ||
Congenital chloridorrhea | + | + | ||||||||||||||||||||||||
Pyloric stenosis | + | − | + | − | - | − | − | + | ↓ | + | ↑ | ↑ | Nl | ↓ | ↓ | ↑ | Nl | Nl | ↑ | Nl to ↑ | Nl | ↓ | Clinical | |||
Villous adenoma | + | + | ||||||||||||||||||||||||
Gastrocystoplasty | + | |||||||||||||||||||||||||
Category | Disease | Hydrogen loss | Accumulation of base | Chloride depletion | Mineralocorticoid excess | Fever | Dyspnea | Edema | Toxic/ill | BP | Dehydration | HCO3− | paCO2 | O2 | Cl− | K+ | Na+ | Ca+ | Mg+ | Renin | Bun | Cr | Urine Cl− | Gold standard diagnosis | Other findings | |
Renal origin | HTN | ↑ | ||||||||||||||||||||||||
Posthypercapnic state | - | - | + | + | - | ± | - | - | Nl | − | ↑ | ↑↑ | ↓ | ↓ | ↓ | ↑ | Nl | Nl | ↑ | Nl | Nl | Nl | Lab data | Chronic respiratory acidosis | ||
Hypomagnesemia | + | − | − | − | − | − | − | − | Nl | − | ↑ | ↑ | Nl | ↓ | ↓ | ↑ | Nl | Nl | ↑ | Nl | Nl | Nl | Lab data | |||
Hypokalemia | + | − | − | − | − | − | − | − | Nl | − | ↑ | ↑ | Nl | ↓ | ↓ | ↑ | Nl | Nl | ↑ | Nl | Nl | Nl | Lab data | |||
Bartter's syndrome | + | + | Nl | ↑ | Nl | |||||||||||||||||||||
Gitelman’s syndrome | + | + | ↑ | |||||||||||||||||||||||
Renal artery stenosis | ↑ | ↑ | Nl | |||||||||||||||||||||||
Liddle syndrome | + | ↑ | ||||||||||||||||||||||||
Renal tumors | ||||||||||||||||||||||||||
Endocrine | Cushing's syndrome | ↑ | ↓ | Nl | ||||||||||||||||||||||
Hyperaldosteronism | Primary | ↑ | ↓ | ↓ | Nl | |||||||||||||||||||||
Secondary | ↓ | |||||||||||||||||||||||||
Adrenal enzyme defects | 11β−Hydroxylase deficiency | ↓ | ↓ | |||||||||||||||||||||||
17α−Hydroxylase deficiency | ↓ | ↓ | ||||||||||||||||||||||||
Hypercalcemia/hypoparathyroidism | + | ↑ | ||||||||||||||||||||||||
Systemic | Cystic fibrosis | + | ||||||||||||||||||||||||
Category | Disease | Hydrogen loss | Accumulation of base | Chloride depletion | Mineralocorticoid excess | Fever | Dyspnea | Edema | Toxic/ill | BP | Dehydration | HCO3− | paCO2 | O2 | Cl− | K+ | Na+ | Ca+ | Mg+ | Renin | Bun | Cr | Urine Cl− | Gold standard diagnosis | Other findings |
- ↑ Galla JH (February 2000). "Metabolic alkalosis". J. Am. Soc. Nephrol. 11 (2): 369–75. PMID 10665945.
- ↑ Máttar, João A.; Weil, Max Harry; Shubin, Herbert; Stein, Leon (1974). "Cardiac arrest in the critically III". The American Journal of Medicine. 56 (2): 162–168. doi:10.1016/0002-9343(74)90593-2. ISSN 0002-9343.
- ↑ Abreo, Kenneth (1993). "The Milk-Alkali Syndrome". Archives of Internal Medicine. 153 (8): 1005. doi:10.1001/archinte.1993.00410080065011. ISSN 0003-9926.
- ↑ Gupta M, Wadhwa NK, Bukovsky R (January 2004). "Regional citrate anticoagulation for continuous venovenous hemodiafiltration using calcium-containing dialysate". Am. J. Kidney Dis. 43 (1): 67–73. PMID 14712429.
- ↑ Luke, R. G.; Galla, J. H. (2012). "It Is Chloride Depletion Alkalosis, Not Contraction Alkalosis". Journal of the American Society of Nephrology. 23 (2): 204–207. doi:10.1681/ASN.2011070720. ISSN 1046-6673.
- ↑ Zaki, SyedAhmed; Lad, Vijay (2011). "Piperacillin-tazobactam-induced hypokalemia and metabolic alkalosis". Indian Journal of Pharmacology. 43 (5): 609. doi:10.4103/0253-7613.84986. ISSN 0253-7613.
- ↑ Meltem, Akkas Camkurt; Figen, Coskun; Nalan, Metin Aksu; Mahir, Kunt; Sebnem, Bozkurt; Mehlika, Isildak; Kasim, Kilic Ahmet; Miyase, Bayraktar (2009). "A hypokalemic muscular weakness after licorice ingestion: a case report". Cases Journal. 2 (1): 8053. doi:10.4076/1757-1626-2-8053. ISSN 1757-1626.
- ↑ Lin, Shih-Hua; Yang, Sung-Sen; Chau, Tom; Halperin, Mitchell L. (2003). "An Unusual Cause of Hypokalemic Paralysis: Chronic Licorice Ingestion". The American Journal of the Medical Sciences. 325 (3): 153–156. doi:10.1097/00000441-200303000-00008. ISSN 0002-9629.
- ↑ Roerig, James L.; Steffen, Kristine J.; Mitchell, James E.; Zunker, Christie (2010). "Laxative Abuse". Drugs. 70 (12): 1487–1503. doi:10.2165/11898640-000000000-00000. ISSN 0012-6667.
- ↑ Sahani, Mandeep M.; Brennan, John F.; Nwakanma, Chukwuemeka; Chow, May T.; Ing, Todd S.; Leehey, David J. (2001). "Metabolic Alkalosis in a Hemodialysis Patient After Ingestion of a Large Amount of an Antacid Medication". Artificial Organs. 25 (4): 313–315. doi:10.1046/j.1525-1594.2001.06714.x. ISSN 0160-564X.
- ↑ Vanpee, Dominique; Delgrange, Etienne; Gillet, Jean-Bernard; Donckier, Julian (2000). "Ingestion of antacid tablets (Rennie®) and acute confusion". The Journal of Emergency Medicine. 19 (2): 169–171. doi:10.1016/S0736-4679(00)00206-7. ISSN 0736-4679.
- ↑ 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.
- ↑ Shapiro, Jennifer R.; Berkman, Nancy D.; Brownley, Kimberly A.; Sedway, Jan A.; Lohr, Kathleen N.; Bulik, Cynthia M. (2007). "Bulimia nervosa treatment: A systematic review of randomized controlled trials". International Journal of Eating Disorders. 40 (4): 321–336. doi:10.1002/eat.20372. ISSN 0276-3478.