Vent Class Lactic Acid

Front 1

Lactic acidosis is defined as:

Back 1

increased lactate levels > 5 mmol/L, with a low pH (<7.35).

Front 2

A persistent lactate level >5 mmol/L, even with fluid and drug resuscitation to treatment for the hypotension, has a mortality rate as high as

Back 2

90%

Front 3

-Shock (cardiogenic, septic, hypovolemic)
-Regional hypoperfusion (limb, mesenteric ischemia)
-Severe hypoxemia
-Severe anemia
-Carbon monoxide poisoning
causes of what type of LA

Back 3

Type A

Front 4

1. B1 (LA occurring in association with and underlying disease)
a. Diabetes mellitus (Ketoacidosis)
b. Liver disease
c. Sepsis (as a separate issue unrelated to hypotension)
2. B2 (LA due to drugs/toxins). Short list: Ethanol, Methanol, Ethylene glycol, Salicylates, Acetaminophen, Epinephrine, Terbutaline, Nitroprusside, Propylene glycol (anti-freeze), Β2 Agonists*
3. B3 (LA due to inborn errors in metabolism)
a. Von Gierke’s disease
4. Miscellaneous
5. Hypoglycemia.
causes of what type of LA?

Back 4

Type B

Front 5

Aerobic pathway:
O2 + Glucose → pyruvic acid → CO2 + H2O + 34 mmol of ATP (1270 kJ of energy)
Anaerobic pathway:
Glucose → pyruvic acid → Lactic acid + 2 mmol of ATP (67 kJ of energy)
process of:

Back 5

citric acid cycle

Front 6

Lactic acid → Pyruvate → Glucose
-process of:

Back 6

Cori cycle

Front 7

the process in which lactic acid is cleared:

Back 7

Gluconeogenesis

Front 8

lactic acidosis should be suspected if a patient has either:

Back 8

an anion gap or hypotension.

Front 9

The normal blood concentration of lactic acid ranges between

Back 9

0.5 to 1.5 mmol/L

Front 10

A persistent lactate level _____ even with fluid and drug resuscitation to treatment for the hypotension, has a mortality rate as high as

Back 10

>5 mmol/L,
90%.

Front 11

potentially causes respiratory depression, severe acute hypokalemia and a leftward shift of the oxyhemoglobin dissociation curve that may worsen tissue hypoxia.
- possible outcomes of:

Back 11

bicarbonate administration