RENAL AND ELECTROLYTE

ResponseGORE
GIT excess acid load

• Vomiting (including pyloric stenosis)
• NGT drainage
• Diarrhoea
• Ileostomy
• Dehydration

Overdose of base

• Antacid overdose, Laxative, milk alkali syndrome
• Massive hartmann’s transfusion
• Iatrogenic use of HCO3

Renal excess acid loss

• Bartter syndrome
• Gitelman syndrome
• Diuretics (H+, K+, Cl- loss)

Endocrine

• Cushing’s syndrome
• Steroid excess
• Hyperaldosteronism (Conn’s Syndrome)

ResponseKetones, Lactate, Renal failure, Tox
CAT MUD PILES
CO, Cyanide, Alcohol, Toluene
Methanol, Uraemia, DKA, Paracetamol, Isoniazid, lactate, Ethanol/Ethylene glycol

ResponseABCD
Addison’s, Bicarb loss (GI, Renal, RTA), Chloride excess, Drugs (Acetazolamide, Acid)
USED CRAP
Ureterostomy, Small bowel fistula, Extra chloride, Diarrhoea, Carbonic Anhydrase inhibitors, Renal Tubular acidosis, Adisons, Pancreatic Ca, Duodenal Fistula.

ResponseDecreased resp drive (CNS, Drugs)
Decreased chest wall movement (neuro (GBS< Tox, Resp (ptx) airway obstruction)
Obstructive pulmonary disease (chronic) (COPD, Asthma, pneumonia,)

ResponseTox - Aspirin, Progesterone
Compensation for metabolic acidosis
Anxiety/Pain/ Alcohol withdrawal
Hypoxia induced (Asthma, altitude, Iatrogenic from ventilator)
Head - CVA/ICH