Young man presents with altered mental status found to have a severe anion-gap metabolic acidosis (142 โ 102 โ 12 = 28 > 12), with exogenous ingestion of an organic acid being the only answer that corresponds with this acid-base disturbance
Excessive loss of bicarbonate = Type 2 renal tubular acidosis (non-anion gap metabolic acidosis)
cbrelandCould also be DKA, but no ketones. Glucose is high, but expected since glucose was given in the hospital. Leads towards ingestion because of lab findings and vignette.+1
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