CO 19 - 27 LOW DIFFERENTIAL DIAGNOSIS

DIFFERENTIAL DIAGNOSIS OF A LOW BICARBONATE

Metabolic Acidosis

     Nongap

          Primary Hyperparathyroidism (HPT)

          Diarrhea

          Vomiting (if contents originate in the ileum)

          Renal Tubular Acidosis

          Renal Insufficiency/Chronic Kidney Disease

          End-Stage Renal Disease

          Ureterosigmoidostomy

     High Gap

          Diabetic Ketoacidosis 

          Ethanol Ingestion

          Methanol Ingestion

          Paraldehyde Ingestion

          Ethylene Glycol Ingestion

          Lactic Acidosis

          Shock

          Sepsis

          Multiorgan Failure

          Thiamine Deficiency

     Rhabdomyolysis

     Addison's Disease

     Hypoxia

     Bowel Infarction

     Postictal

     Medications

          Epinephrine

          Nitroprusside

          Theophylline Toxicity 

     Diabetic Ketoacidosis

     Renal Failure

Compensated Respiratory Alkalosis

     Increased A-a Gradient

          Congestive Heart Failure

          Asthma

          Pneumonia

          Pulmonary Embolism

          Pneumothorax

     Normal A-a Gradient

          Sepsis

          Hyperventilation

          Encephalopathy

          Cirrhosis