#metabolic acidosis

[emergingtrendsupside]

Read this helpful article to learn about Metabolic Acidosis causes, signs, and treatments. Gain more knowledge about it.

[chicago-geniza]

I have been taking prescription migraine medication for 21 years. My first sumatriptan prescription can legally drink in the United States. Anyway my migraine is coming back and I am certain it's the barometric pressure but eugjgjfhfh

[shallowseeker]

most challenging day in a long time and i come home to nice comments whaaaaaaaaaaaaat *_*

[cannabiscomrade]

This is a hurdle I’ve been seeing a lot lately now that I’m learning more about tubie life but

Fat people can require feeding tubes

Fat people can be malnourished

Fat people are deserving of enteral/parenteral nutrition and the current standard of qualifying for alternate nutrition often demands that fat people face a more extreme depletion of nutrition before they’re given the same interventions as mid-size and skinny people. One of the determinations of tube placement is involuntarily losing 5-10% of your body weight within 6 months, which can be a significant impact for someone whose starting weight is 220lbs vs 120lbs. Starvation can still send the body into metabolic acidosis/starvation ketoacidosis long before the bigger person hits that 5-10% lost threshold.

Weight loss/diet culture compounds with this because any weight lost by a fat person is often seen as a “good” thing and not documented as a medical problem or a negative symptom. I lost so much weight before my tube was placed that I am now mid-size, and it has already had an impact on my treatment. Most nurses and other healthcare providers are now shocked that I’ve lost over 60lbs in a few months, instead of congratulatory. I’m no longer “looking great”, I “look sick”. Despite that, I still had another nurse look at me and say “you look like you can eat and drink, why do you have a feeding tube?” Sorry- I didn’t know you could just look at me and determine that, considering my stomach is paralyzed.

Enteral feeding is also not even developed to be accessible for larger people. G/GJ tubes have approximately 10cm of tube designed for use inside the body (stoma). Fat people sometimes need to move straight to total parenteral nutrition because the devices themselves lack accessibility. TPN is associated with higher risks than enteral feeding and is often used as a “last resort”, but yet a lot of larger people don’t have another option.

[howtofightwrite]

if someone was in a bad car crash in snowy conditions with serious injuries, and it was gonna take a bit for emergency services to reach them, would mild-moderate hypothermia help keep them alive - blood loss speaking, at least - or would it do nothing / kill them faster

It is apparently the final option. Even mild hypothermia increases the risk of bleeding to death, so while hypothermia can slow your metabolism (granted, by that point, you have much bigger problems, as you're literally freezing to death), it also appears to impair your blood's ability to clot.

There are some, potential, beneficial applications, in a surgical environment, for inducing hypothermia, but those are also weighed against the fact that if the patient is bleeding, it won't stop. In some specific cases, coagulation can be medically induced while the patient is still hypothermic, but that only works if the patient is suffering from acidosis (a condition where their bodily fluids are too acidic.) Acidosis isn't extremely common, though you might see it from an untreated diabetic, alcoholics, hypoglycemia, altitude sickness, someone who's been heavily vomiting recently... it's a weird mix of potential situations.

So, it is possible if someone's coming home from their unusually strenuous workout, gets in an auto accident, starts to go hypothermic, and EMS are already on the scene, their clotting factor could, theoretically, be restored before dealing with they hypothermia... but that's not really the question.

Without medical attention, hypothermia combined with bleeding (even, relatively minor bleeding) is a bad situation. The combination is significantly more dangerous than either of these factors would be on their own.

So, apparently, it's the latter, it will kill them faster, because their blood won't clot (at least, not as efficiently as it normally would.)

-Starke

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[reality-detective]

Let's investigate the 4 chemicals in Palestine Ohio's train derailment and their so-called slow burn operation that our government said was safe.👇

1. VINYL CHLORIDE

A chemical warfare agent in WWII ☠️

Is vinyl chloride harmful to human health?

⚠️Exposure to vinyl chloride may increase a person's risk of developing cancer. Human and animal studies show higher rates of liver, lung and several other types of cancer. Being exposed to vinyl chloride can affect a person's liver, kidney, lung, spleen, nervous system and blood.

How much vinyl chloride cause cancer?

Studies of long-term exposure in animals showed that cancer of the liver and mammary gland may increase at very low levels of vinyl chloride in the air (50 ppm). Lab animals fed low levels of vinyl chloride each day (2 mg/kg/day) during their lifetime had an increased risk of getting liver cancer.

Is vinyl chloride a hazardous waste?

⚠️Vinyl Chloride is hazardous to the environment.

2. ETHYLENE GLYCOL

What is ethylene glycol used in?

DESCRIPTION: Ethylene glycol is a useful industrial compound found in many consumer products. Examples include antifreeze, hydraulic brake fluids, some stamp pad inks, ballpoint pens, solvents, paints, plastics, films, and cosmetics.

How is ethylene glycol harmful to humans?

An overdose of ethylene glycol can damage the brain, lungs, liver, and kidneys. The poisoning causes disturbances in the body's chemistry, including metabolic acidosis (increased acids in the bloodstream and tissues). The disturbances may be severe enough to cause profound shock, organ failure, and death.

How does ethylene glycol affect the brain?

Ethylene glycol (EG) is a toxic alcohol that causes central nervous system depression and multiple metabolic abnormalities including a high anion gap metabolic acidosis (HAGMA), elevated osmolal gap (OG), and acute kidney injury. Few case reports of EG intoxication report brain MRI findings.

Is ethylene glycol a carcinogen?

🚩EPA has not classified ethylene glycol for carcinogenicity. Chronic Effects (Noncancer): The only effects were noted in a study of individuals exposed to low levels of ethylene glycol by inhalation for about a month were throat and upper respiratory tract irritation.

Is ethylene glycol monobutyl ether harmful to humans?

The substance is irritating to the eyes, skin and respiratory tract. The substance may cause effects on the central nervous system, blood, kidneys and liver. A harmful contamination of the air will be reached rather slowly on evaporation of this substance at 20°C.

3. MONOBUTYL ETHER

What is the use of monobutyl ether?

It is used as a solvent in surface coatings in paints; as a coupling agent in metal and household cleaners; as an intermediate in chemical production; and is also found in brake fluids and in printing ink.

Is butyl ether toxic?

⚠️Acute Health Effects☠️

The following acute (short-term) health effects may occur immediately or shortly after exposure to Butyl Ether: * Contact can irritate the skin and eyes. * Repeated or prolonged skin contact may cause rash. Breathing Butyl Ether can irritate the nose and throat causing coughing and wheezing.

Is ether toxic to humans?

⚠️Breathing Diethyl Ether can cause drowsiness, excitement, dizziness, vomiting, irregular breathing, and increased saliva. High exposure can cause unconsciousness and even death.

Is ether a carcinogen?

► Bis(Chloromethyl) Ether is a CARCINOGEN in humans. There may be NO safe level of exposure to a carcinogen, so all contact should be reduced to the lowest possible level.

Combustible. Above 60°C explosive vapour/air mixtures may be formed. NO open flames. Above 60°C use a closed system and ventilation.

4. ETHYLHEXYL ACRYLATE

Is ethylhexyl acrylate toxic?

Like any reactive chemical, 2-Ethylhexyl acrylate can be hazardous if not handled properly. May be harmful if swallowed. Ingestion may cause gastrointestinal irritation or ulceration. Limited dermal contact or vapour concentrations attainable at room temperature are not hazardous on single short duration exposures.

Is Ethylhexyl acrylate copolymer safe?

Although the monomers may be toxic, the levels that would be found in cosmetic formulations are not considered to present a safety risk. Accordingly, these Acrylate Copolymers are considered safe for use in cosmetic formulations when formulated to avoid irritation.

Are acrylates safe?

The International Agency of Research on Cancer as well as the U.S. Environmental Protection Agency (EPA) have classified acrylates as a possible human carcinogen. Exposure to acrylates has been linked to skin, eye, and throat reactions [1] as well as more serious health consequences such as: Cancer.

Is ethylhexyl harmful for skin?

Ethylhexylglycerin is not safe due to its performance as a contact allergen.

Is ethyl acrylate carcinogenic?

⚠️Cancer Hazard☠️

* Ethyl Acrylate may be a CARCINOGEN in humans since it has been shown to cause stomach cancer in animals.

🚩Spoiler Alert⚠️ It's NOT safe and in fact it is highly toxic☠️

This will affect millions of people and it may flow into the Mississippi river as well. 🤔

[gynandromorph]

so strangulation is a running theme in idletry. an important one. with shiloh, if the prior content thus far hadn't made it obvious. the thing about naked mole rats is that they can survive without oxygen for up to 20 minutes. they do this by metabolizing fructose like a plant, circumventing the need for oxygen. this can be a problem for a mole rat who wants some kind of choke high. however, manual strangulation frequently incapacitates and kills by applying pressure on the arteries in the neck, which are much more essily compressed than the trachea. even a mole rat will black out (and die) if blood is completely cut off from the brain, at the same speed as any mammal, which is good news for shiloh.

relatedly, one may know from watching enough cave diving videos that a single gulp of air that is mostly carbon dioxide will incapacitate a human instantly due to a phenomenon called acute respiratory acidosis, where the sudden uptake of carbon dioxide beyond what the kidneys and lungs can handle causes the blood to become fatally acidic. this is a separate phenomenon from dying due to a lack of oxygen to power metabolic processes. I wondered if they are also resistant to high CO2 concentrations; it turns out that they aren't just resistant to high CO2 – naked mole rats may literally depend on high concentrations of CO2 produced by huddling together in deep tunnels, as studies have observed that naked mole rats can start to hyperventilate and have seizures as they enter respiratory alkalosis, or, the opposite of acidosis. this is due to a complicated mutation that affects GABAergenic processes due to a cascade of molecular interactions. GABA is an important inhibitory chemical that regulates activity in the brain, and it is why GABA targeted drugs such as benzodiazepines function as immediate rescue medications to stop cluster seizures.

tangentially, shiloh is shown in the comic to take benzos recreationally, so I will have to think about that. it is not an issue, of course, because these seizures in naked mole rats can be stopped with the same medications, and they likely react the same way to the drugs as other mammals, but produce and regulate GABA differently as an adaptation to high CO2 environments. they really are little freaks of nature

[justkidneying]

ANOTHER regen question!

Let's see if I phrase this one right it's been rolling in my brain a bit

Assumptions are the character heals a slower than Wolverine and they've just suffered some serious blood loss. Like they lost ~3L of it and the wound has now closed up and the body's working to create as much blood as possible.

Given how bone marrow is where blood comes from, what sorts of things might they have to deal with in the recovery period? Like, as the body is taxing the marrow like that (and/or whatever else it has to)?

I'm going to assume this is a ~200lb man, just to give some leeway. So a big guy like this would have maybe 6 liters of blood in him (most humans range from 4-6 L). If he loses ~3 L, I would say he would probably just die. If blood loss is >40%, that's a Class IV hemorrhage, which presents with absent peripheral pulses, hypotension (low blood pressure), and no peepee output. This person will go into hemorrhagic shock. Since they lack the oxygen-carrying hemoglobin that is found in blood, they will not be able to supply oxygen to their tissues. This stops the usually metabolic processes and switches the body to anaerobic metabolism, which makes lactic acid and very little ATP (energy). Lactic acid leads to acidosis. Acidosis leads to cell death, coma, and plain ole death. He will die.

But wait! He's got regenetative powers to save him, right? No. If his powers aren't magical, then he will still die. Because regeneration is based on being able to replicate cells very quickly, he would need to do it fast enough to beat the cells that are dying. Unfortunately, he doesn't have enough ATP to do normal cell stuff and make a bunch more. Replication of cells requires a lot of ATP (energy). So he will still die.

Now, let me answer the second question, and we will go back to when he is still alive. Let's change it so he only lost ~30% of his blood volume (1.8L). He's still not doing good (he has Class III hemorrhage) but he can live. This will present with pallor, coolness in the limbs, altered mental status, narrowing blood pressure (the top and bottom numbers are getting close together), increased respiratory rate, and increased heart rate. The body is trying to keep blood flow to the vital organs. Let's say he survives and now he's home and trying to recover.

Blood has a lot of things in it, but the important bits are plasma (the liquid bit which makes up ~55% of blood), red blood cells (they carry oxygen), platelets (for clotting) and white blood cells (part of the immune system).

The most important one here are the RBCs. 90% of plasma is water, and you won't die right away without the other ones. The body measures RBCs through the kidney. If the kidney sees that you don't have enough of them, then it sends a hormone (EPO) to the spongey inner bone where blood is made. EPO causes more stem cells to turn into RBCs (instead of WBCs or platelets). To make these, you need iron. The iron stores of the body will be used, and you will take up more iron from your food.

Overall, I'd say the guy will feel like shit, and he should probably take a break for about 3 months while he replinishes his blood supply. He should eat foods high in iron, maybe take an iron supplement. But he'll be anemic while he recovers and be low on those other blood cells. Honestly, his regen powers aren't that useful here. They were useful in fixing whatever caused the blood loss, keeping him from losing a ton of cells to blood supply issues, and that's about it. If he doesn't have an advanced factor, then he can't really be helped with making more RBCs.

I hope I answered your question, and thank you very much for asking it!

[skyloftian-nutcase]

I spent entirely too long getting confused about increased anion gap metabolic acidosis good grief. Just sign me up for med school already 🥲😩

On to neuro weeeeeeee

[docbe]

I know that it’s a dangerous pastime looking up medical information online, but also like, woulda been nice to know the meds they put me on for migraines had detox centers and help hotlines and shit

I was thinking of tapering off bc I wasn’t sure it was really helping much, and then the neuro office that prescribed it closed, so it’s like “guess it’s happening now!” So I been cuttin up my lil pills to taper over 3-4 weeks (which I DO NOT RECOMMEND DOING normally, just for the record, bc like half-life in the body is different for diff meds etc and you really can’t just be doing that with everything…but did my research and desperate times and all that)

And I’ve actually been feeling pretty decent? The one time I missed a dose before, my neck/shoulder muscles seized for like a week, but it’s been going well…and I’m kinda wondering if I wasn’t having side effects that kinda just blended in with everything else

And ALSO two of my meds are apparently associated with mild metabolic acidosis which also has shit that looks a lil too familiar and I’m like, was no one gonna like. Mention that. I mean it could really be nothing but also I’m gonna be mad if it turns out that “oh tee hee yeah that’s part of the issue”

[chicago-geniza]

Great news. It is 70 degrees out realfeel in the 80s with no cloud cover so I went to the Korean grocery store then got home, vomited about a pint of bile, and briefly passed out. POTS will kill me via climate change AMA

[killed-by-choice]

“Alina Roe” 31 (USA 2023)

The unidentified woman known only as “Alina Roe” or FDA Adverse Event case 21922968 was killed by the use of the “safe and legal” abortion pill. Her case was reported to the FDA by an anonymous healthcare professional. If not for this whistleblower, Alina’s case could have easily gone entirely unreported.

Alina was 31 when she underwent a chemical abortion using mifepristone and misoprostol. She died on January 7, 2023.

Another source separately reported a death to the FDA (22147816) that appears to be Alina’s case. Because of the highly ineffective report system, it’s hard to confirm if this is Alina or not. Unless another 31-year-old woman was killed by chemical abortion using the same drugs on the exact same date, it can be concluded that this is probably another report of Alina’s case. If so, Alina suffered hypotension, bleeding, uterine enlargement, nausea, metabolic acidosis and an elevated white blood cell count. She was likely in excruciating pain before dying.

FDA Adverse Event Report case 21922968 (see also 22147816)

[teamfortresstwo]

I still don’t know about salus but no skills au Eris would have autosomal dominant polycystic kidney disease, which caused chronic kidney disease and then metabolic acidosis.

Ooooh . Woah his kidneys are getting fucking destroyed huh

[emsee22]

Thing I Can Make Out On The White Board:

1) The CRM is clearly planning to make a move on Portland. We know this because the map the promo shows, the top left says Portland and Post Operation, that latitude and longitude for Portland, Oregon are on the board. (Also, the World Beyond spinoff, which I have not watched)

2) I think the π symbol could be a reference to pizza or an implication that the story is now coming full circle.

3) RPED and marine - marine is a military branch and I think RPED can either stand for Respiratory Protective Escape Device or Rapid Prototyping Experimentation Demonstration. We know that the CRM has made devices to attack people with chlorine gas, we also know that they are performing experiments.

4) Radio G7 Span and East of River - G7 is the Group of 7 that includes Canada, France, Germany, Italy, Japan, UK, and the US. It is a government thing. I think this shows the widespread reach of the CRM. When I looked up East of River, it brought up Washington DC, as East of the River is a part of DC called the East End.

5) Food Lines/Inventory Seeds RW 32.62527 - I can't put a whole lot of meaning to this beyond possibly trying to attack Portland's food supply, unless seeds are referring to their bomb capsules. Both the Seed stand and the seed mention made me think back to the season 3x1 Seed but that can just be a coincidence.

6) Code 3362, FL/only - I haven't been able to find what code 3362 means, but I think FL means food lines OR front lines.

7) Engage -> Assess -> Execute -> Reclamation -> PPP exception - I think this is just how they keep files on communities and document them. I am uncertain exactly what the PPP exception is, although I have made 2 posts on it. I think it means Power Projection Platforms in regards to what the CRM views as assets (A's who can be reformed the the CRMs benefit, and control military forces) or medically it refers to glycolysis and the Pentose Phosphate Pathway and how the body responds to methanol (metabolic acidosis).

8) Echelon Exception - we are aware that there is something called the Echelon Briefing. We know that historically Echelon was a government surveillance program (which is similar to how the CRM knows about all these communities). We also know that Echelon literally means rung of a ladder or level.

9) Intel / Rules / Contact Park - I cannot read anything that it says in between the section titles. I do know there was a character on Fear the Walking Dead: Dead on the Water (or something along those lines) named Park. That show was about the USS Pennsylvania (I think) going against its orders to fire up on Chicago.

10) Refinery C2H5OH1 - The CRM is manufacturing ethanol. We know ethanol to be alcohol, the most concentrated form being moonshine. We know that if not made properly, it becomes methanol which is poisonous to the body because our body turns it into formaldehyde. I think this is why Beth says "bad moonshine can make you go blind" and I also think this is why Alone takes place in a funeral home. (I also think Alone took place in a funeral home to emphasize the fact that Beth did not get a funeral). I think this is Pharmakon, poison and cure coming full circle. Even in the episode Still, Peach Schnapps was a poison and Moonshine was the cure. (Daryl said Peach Schnapps is not good and Moonshine is a real first drink).

This is just info, I can't really make the best sense of it all as I have no watched any of the spinoffs and haven't seen past Carl's death in the show. (My fiance and I are only on 5x7 of our rewatch)

[mcatmemoranda]

When caring for a patient in cardiac arrest, it is important to recognize reversible causes for the arrest and address them. This is especially important with PEA and asystole, which often have reversible underlying causes. The mnemonic Hs and Ts can help you to remember the reversible causes of cardiac arrest.

Hypovolemia

Hypoxia

Hydrogen ion excess (acidosis)

Hyper- or hypokalemia

Hypothermia

Toxins

Tamponade

Tension pneumothorax

Thrombosis (pulmonary embolism)

Thrombosis (myocardial infarction)

 In patients with metabolic acidosis, the administration of an initial dose of sodium bicarbonate (1 mEq/kg) may be indicated. If administering sodium bicarbonate, ensure adequate ventilation for removal of carbon dioxide or sodium bicarbonate may worsen intracellular and tissue acidosis.

Suspect hyperkalemia in all patients with acute or chronic renal failure and in those who had a wide-complex ventricular rhythm and tall, peaked T waves on ECG before arrest. Several measures may be taken to reduce potassium levels, including administering sodium bicarbonate, glucose and insulin, or nebulized albuterol. Sodium bicarbonate is preferred in patients with cardiac arrest caused by hyperkalemia because it causes a rapid shift in serum potassium level. Other therapies take much longer to work.

Suspect hypokalemia in patients with dehydration or overuse of diuretics. In hypokalemia, flat T waves, prominent U waves and possibly prolonged QT intervals may be seen on ECG before arrest. Treatment is with intravenous (IV) administration of a dilute solution of potassium chloride.

[justkidneying]

So you know when you get drunk and feel like shit the next day? Have you ever wanted to be able to drink without getting a hangover? Well, I can't really help you there, but I can at least tell you why hair of the dog doesn't work.

Ethanol (CH3CH2OH): this is normal drinking alcohol. When you drink it, most of it gets dumped into your blood and into the liver. What does the liver do with it? It breaks it down into acetaldehyde (which is very toxic) and then breaks that down to acetate. The enzymes involved are Alcohol Dehydrogenase (in the cytosol) and Acetaldehyde Dehydrogenase (in the mitochondria). These both use NAD+ (which is needed for normal metabolism) to do their thing, which leaves us with NADH.

So why is drinking bad for you? Cause it inhibits gluconeogenesis, causes lactic acid build up, and damages your cells (yes, you can handle it and drinking in moderation is fine, but molecularly, it is bad).

Cell Damage: acetaldehyde damages pancreas, brain, liver, and GI tract. It also impairs memory and coordination (obviously, lol), and makes you tired (wow who could have guessed that??). Basically, this compound is the reason you feel like shit. Acetaldehyde is bad for you, but you have to make it to get rid of ethanol. Some people (especially those of Asian descent) don't have enough acetaldehyde dehydrogenase. This causes a build up, so they feel worse and get that nice red face when they drink.

Lactic Acid Build Up: okay so remember all that NADH we made to break down ethanol? It's making us have a bad NADH to NAD+ ratio. We really need that NAD+ to accept an electron and allow us to make ATP (energy). So how can we make more of that? We are going to convert pyruvate (made from breaking down glucose) to lactate. What does lactate cause? LACTIC ACIDOSIS! That is bad.

Inhibition of Gluconeogenesis: do you know what you do when you haven't eaten in a little while? You make glucose (gluconeogenesis). You can make glucose from all kinds of shit, isn't that cool? One of these things is called oxaloacetate. When you have no NAD+, you convert oxaloacetate to malate. You can't make glucose from that. The high NADH to NAD+ ratio also inhibits the gluconeogenesis dehydrogenases needed to make glucose. What I'm getting at here is hypoglycemia (low blood sugar) because you have no usable glucose and you can't make any.

So why is this bad? Well, because you don't have glucose, but your cells are still working (and getting damaged :() you need to give some energy to them to function. This comes in the form of ketone bodies. This is really only an issue for heavy drinkers, but over time and with increased frequency, drinking can lead to ketoacidosis.

But yeah, the reason you feel bad after drinking is mostly due to how toxic acetaldehyde is. That's what causes head ache, nausea, and memory problems (from all the damage it does to those cells). So no, drinking more won't get rid of a hangover, and hair of the dog does not work. Eating food helps though, so you can finally have some glucose to work with.

Now some more notes:

Fatty Liver: this is going to be more prevalent in heavy drinkers, but it happens because you convert DHAP to glycerol-3-phosphate. G3P can combine with fatty acids to make triglycerides, which can go live in the liver and cause hepatosteatosis (fatty liver). This is also bad.

Methanol (CH3OH): this is also called wood alcohol, and can most commonly be drunk via bootleg liquor. Your body uses the same enzymes to break it down, but this time it is making formaldehyde and fomic acid. Fomic acid causes ocular toxicity (aka going blind) and brain damage. So make sure you trust whoever you get your bootleg liquor from, okay?

Ethylene Glycol (OHCH2CH2OH): this is antifreeze. Same enzymes again, but you get glycoaldehyde. This then becomes oxalic acid and glyoxylic acid. These cause lactic acidosis and calcium oxalate formation, which crystalizes in the kidneys, causing renal failure.

Final note: your body can handle drinking, like 1-2 drinks per day. I'm not your mom, so do whatever you want, but at least now you know why you feel like shit as your friends hold your hair back so you can puke in the shitty bar toilet :)