A patient with metabolic acidosis has a markedly increased osmolal gap. Which cause should be considered first…

Question

A patient with metabolic acidosis has a markedly increased osmolal gap. Which cause should be considered first?

Accepted Answer

보기 3: Ingestion of an alcohol such as methanol or ethylene glycol

A widened osmolal gap means that small molecules not included in the calculated osmolality are present in the blood. Ingestion of alcohols such as methanol or ethylene glycol is the classic cause. Ketoacidosis and renal failure raise the anion gap without producing a large osmolal gap.

Answer

보기 1: Diabetic ketoacidosis with marked accumulation of ketoacids in blood

Answer

보기 2: Renal failure with retention of organic acids and urea

Answer

보기 4: Lactic acidosis from sepsis and tissue hypoperfusion

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A patient with metabolic acidosis has a markedly increased osmolal gap. Which cause should be considered first?

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