Acidosis: Difference between revisions

Revision as of 23:54, 12 March 2026

Metabolic acidosis
- Anion gap acidosis (mnemonic: GOLDMARK or CAT MUDPILES)
  - Diabetic ketoacidosis (DKA)
  - Alcoholic ketoacidosis
  - Starvation ketoacidosis
  - Lactic acidosis
    - Metformin-associated lactic acidosis
    - Type A lactic acidosis (tissue hypoperfusion: shock, sepsis, mesenteric ischemia, cardiac arrest, seizures, carbon monoxide)
    - Type B lactic acidosis (impaired metabolism: liver failure, malignancy, medications, thiamine deficiency)
  - Toxic alcohols
    - Methanol
    - Ethylene glycol
  - Salicylate toxicity
  - Uremia / Renal failure
  - Pyroglutamic acidosis (5-oxoprolinemia; associated with chronic acetaminophen use, malnutrition, sepsis)
  - Iron
  - Isoniazid
  - Cyanide
  - D-lactic acidosis (short bowel syndrome)
  - Toluene (initially anion gap; may convert to non-anion gap)
- Non anion gap acidosis (mnemonic: HARDUPS or USEDCARP)
  - Renal tubular acidosis
  - Diarrhea (most common cause of NAGMA)
  - Hyperchloremic acidosis (iatrogenic — excessive NS resuscitation)
  - Ureteral diversion (ileal conduit, ureterosigmoidostomy)
  - Acetazolamide / carbonic anhydrase inhibitors
  - Adrenal insufficiency
  - Pancreatic fistula / drainage
Respiratory acidosis
- Acute (CNS depression, airway obstruction, neuromuscular disease, pneumothorax, flail chest)
- Chronic (COPD, obesity hypoventilation syndrome, neuromuscular disease, chest wall deformity)
Mixed acid-base disorders (commonly encountered in the ED; e.g. combined metabolic acidosis + respiratory acidosis in overdose; combined anion gap + non-anion gap in DKA with NS resuscitation)

@@ Line 1: / Line 1: @@
 *[[Metabolic acidosis]]
-**[[Non anion gap acidosis]]
+**[[Anion gap acidosis]] (mnemonic: '''GOLDMARK''' or '''CAT MUDPILES''')
-***[[Anion gap acidosis]]
+***[[Diabetic ketoacidosis|Diabetic ketoacidosis (DKA)]]
+***[[Alcoholic ketoacidosis]]
+***[[Starvation ketoacidosis]]
 ***[[Lactic acidosis]]
 ****[[Metformin-associated lactic acidosis]]
+****[[Type A lactic acidosis]] (tissue hypoperfusion: shock, sepsis, mesenteric ischemia, cardiac arrest, seizures, carbon monoxide)
+****[[Type B lactic acidosis]] (impaired metabolism: liver failure, malignancy, medications, thiamine deficiency)
+***[[Toxic alcohols]]
+****[[Methanol toxicity|Methanol]]
+****[[Ethylene glycol toxicity|Ethylene glycol]]
+***[[Salicylate toxicity]]
+***[[Uremia]] / [[Renal failure]]
+***[[Pyroglutamic acidosis]] (5-oxoprolinemia; associated with chronic acetaminophen use, malnutrition, sepsis)
+***[[Iron toxicity|Iron]]
+***[[Isoniazid toxicity|Isoniazid]]
+***[[Cyanide toxicity|Cyanide]]
+***[[D-lactic acidosis]] (short bowel syndrome)
+***[[Toluene]] (initially anion gap; may convert to non-anion gap)
+**[[Non anion gap acidosis]] (mnemonic: '''HARDUPS''' or '''USEDCARP''')
+***[[Renal tubular acidosis]]
+****[[Renal tubular acidosis type 1|Type 1 (Distal) RTA]]
+****[[Renal tubular acidosis type 2|Type 2 (Proximal) RTA]]
+****[[Renal tubular acidosis type 4|Type 4 (Hypoaldosteronism) RTA]]
+***[[Diarrhea]] (most common cause of NAGMA)
+***[[Normal saline toxicity|Hyperchloremic acidosis]] (iatrogenic — excessive NS resuscitation)
+***Ureteral diversion (ileal conduit, ureterosigmoidostomy)
+***Acetazolamide / carbonic anhydrase inhibitors
+***Adrenal insufficiency
+***Pancreatic fistula / drainage
 *[[Respiratory acidosis]]
-*[[Renal tubular acidosis]]
+**Acute (CNS depression, airway obstruction, neuromuscular disease, pneumothorax, flail chest)
+**Chronic (COPD, obesity hypoventilation syndrome, neuromuscular disease, chest wall deformity)
+*[[Mixed acid-base disorders]] (commonly encountered in the ED; e.g. combined metabolic acidosis + respiratory acidosis in overdose; combined anion gap + non-anion gap in DKA with NS resuscitation)
-==See also==
+==See Also==
 *[[Acid-base disorders]]
+*[[Metabolic alkalosis]]
+*[[Respiratory alkalosis]]
+*[[Anion gap]]
+*[[Osmolar gap]]
+*[[Toxic Alcohols]]
+*[[Diabetic Ketoacidosis]]
+*[[Lactic Acidosis]]
+*[[Sepsis]]
 [[Category:FEN]]