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What are the causes of ANION gap metabolic acidosis? What is the approach to investigating?,”KARMELKetosis (diabetic, alcoholic, starvation)ASA (salicylates)Renal (AKI, uremia)MethanolEthylene glycolLactic acid (Type B – Metformin, Iron, INH, Valproate
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Read moreWhat are the causes of NON-ANION gap metabolic acidosis?,”HARDASSHyperalimentation (TPN pH 5.8)Addison’s disease (HyperK)Renal Tubular AcidosisDiarrhea (GI loss – ureteroenterostomies
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Read moreWhat are causes of metabolic alkalosis?,”Intracellular shifting:1. HypokalemiaGI losses:1. Vomiting2. Diarrhea (normally diarrhea is alkali, but acidosis occurs in congenital chloride diarrhea, villous adenoma
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Read moreWhat are the types of renal tubular acidosis?,”I (classic) – REDUCED H+ EXCRETION, distal tubule. Urine pH >5.5. Plasma HCO3 <15. Renal stones. II - IMPAIRED BICARB REABSORPTION, proximal tubuleIV - IMPAIRED CATION EXCHANGE
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Read moreWhat are causes and lab/urine findings for type I RTA? What is the characteristic electrolyte finding?,”REDUCED H+ EXCRETION in collecting tubule:1. Genetic2. Obstructive nephropathy – Sickle cell, nephrocalcinosis, UTI3. Autoimmune* (Sjogrens, SLE).4. Drugs (Ampho B, Lithium
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Read moreWhat are 4 DDx of basophilic stippling on blood smear?
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Read moreWhat are causes and lab/urine findings for type II RTA? What is the characteristic electrolyte finding?,”IMPAIRED BICARB REABSORPTION in proximal tubule:1. Multiple myeloma, Amyloidosis2. Fanconi syndrome – cystinosis3. Carbonic anhydrase inhibitors4. Vitamin D deficiency5. Lead nephropathy.HYPOKALEMIC HYPERCHLOREMIC METABOLIC ACIDOSIS (Cl replaces HCO3 in circulation).Impaired bicarb reabsorption also affects NaCl reabsorption, leading to salt wasting. Aldosterone is upregulated. Plasma HCO3 > 15 mmol/L
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Read moreWhat is the cause of signet rings in RBC on a blood smear?
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Read moreWhat are causes and lab/urine findings for type IV RTA? What is the characteristic electrolyte finding?,”IMPAIRED CATION EXCHANGE. Addisonian syndrome results in impaired excretion of H+ and K+:1. DM (>50%)2. Addisons, spironolactone3. Interstitial nephritis (NSAIDs, ACEi, trimethoprim, heparin)HYPERKALEMIA due to defect in cation-exchange in distal tubule
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