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ACIDOSIS |
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metabolic acidosis: |
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increased acid production:
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diabetic ketoacidosis acetazolamide [increased renal bicarbonate loss]salicylate intoxication [+ respiratory alkalosis] |
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lactic acidosis: |
vigorous exercise [physiological; transient]liver failure respiratory failure cardiac failure renal failure shock septicaemia starvation pre-eclampsia vomiting leukaemia type I glycogen storage disease |
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drugs / toxins: |
alcohol methanol salicylates ethylene glycol biguanides, esp. phenformin |
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decreased renal acid excretion: |
renal failure (acute or chronic)renal tubular acidosis [+ hypokalaemia]potassium-sparing diuretics hypoadrenalism |
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gastrointestinal loss of alkali (bicarbonate) : |
diarrhoea [also hyponatraemia and hypokalaemia]fistulas aspiration of intestinal contents |
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exogenous alkali: |
administration of ammonium chloride ingestion of antacids |
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other: |
uterosigmoidostomy [reabsorption of excreted acid; also hypokalaemia] |
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respiratory acidosis: |
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acute type II respiratory failure: |
exacerbations of chronic obstructive pulmonary disease respiratory suppressants (opiates) upper airway obstruction severe life-threatening asthma major chest trauma sleep apnoea syndromes respiratory arrest acute brainstem / cord lesions [involving respiratory centre or respiratory muscles] respiratory muscle paralysis [various causes] |
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chronic type II respiratory failure: |
chronic obstructive pulmonary disease large pleural effusions severe kyphoscoliosis terminally in any progressive respiratory disease |
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