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Medicine

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Endocrine

Question
12 out of 14
 

Deficiency of which of the following vitamins can lead to lactic acidosis (AIIMS Nov 2010)



A B1
B B2
C B6
D B12

Ans. A

B1

LACTIC ACIDOSIS

1). Lactic acidosis is characterized by low pH in body tissues and blood.

2). Elevated lactate is indicative of tissue hypoxia, hypoperfusion and state of acute circulatory failure.

3). Lactic acidosis is characterized by lactate levels >5 mmol/L and serum pH <7.35.

4). It is very common in type 2 diabetic patient who are on metformin therapy.

5). Signs:

a. Deep and rapid breathing

b. Vomiting

c. Abdominal pain.

Extra Edge:

The Cohen-Woods classification categorizes causes of lactic acidosis as follows:

Type A: Decreased perfusion or oxygenation

Type B:

B1: Underlying diseases (sometimes causing type A)

B2: Medication or intoxication

B3: Inborn error of metabolism

Treatment:

1). Lactic acidosis is typically associated with tissue hypoperfusion. Appropriate measures include treatment of shock, restoration of circulating fluid volume, improved cardiac function, identification of sepsis source and appropriate therapy, and resection of any potential ischemic regions.

2). Sodium bicarbonate is given I/V

3). Thiamine

4). Thiamine deficiency may be associated with cardiovascular compromise and lactic acidosis. The response to thiamine repletion may be dramatic and potentially lifesaving.

(Ref: Hari- 18th ed. Pg- 597)

Endocrine Flashcard List

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