Wallach's Interpretation of Diagnostic Tests: Pathways to Arriving at a Clinical Diagnosis (1136 page)

BOOK: Wallach's Interpretation of Diagnostic Tests: Pathways to Arriving at a Clinical Diagnosis
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   Acute acidosis (especially hyperchloremic metabolic acidosis; less with respiratory; little with metabolic acidosis due to organic acids) (e.g., diabetic ketoacidosis, lactic acidosis, acute renal failure, acute respiratory acidosis)
   Decreased insulin
   Beta-adrenergic blockade
   Drugs (e.g., succinylcholine, great excess of
Digitalis
, arginine infusion)
   Use of hypertonic solutions (e.g., saline, mannitol)
   Intravascular hemolysis (e.g., transfusion reaction, hemolytic anemia), rhabdomyolysis
   Rapid cellular release (e.g., crush injury, chemotherapy for leukemia or lymphoma, burns, major surgery)
   Urinary diversion
   Ureteral implants into jejunum
   In neonates—dehydration, hemolysis (e.g., cephalohematoma, intracranial hemorrhage, bruising, exchange transfusion), acute renal failure, CAH, adrenocortical insufficiency

Decreased In

   Excess renal excretion (in patients with hypokalemia, urine potassium, >25 mmol in 24 hours or >15 mmol/L implies at least a renal component)
   Osmotic diuresis of hyperglycemia (e.g., uncontrolled diabetes)
   Nephropathies

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