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Metabolic Acidosis Coma

By Dr. Ahmed Hafez

Practice Essentials Metabolic acidosis is a clinical disturbance characterized by an increase in plasma acidity. Metabolic acidosis should be considered a sign of an underlying disease process. Identification of this underlying condition is essential to initiate appropriate therapy.  The initial therapeutic goal for patients with severe acidemia is to raise the systemic pH above 7.1-7.2, a level at which dysrhythmias become less likely and cardiac contractility and responsiveness to catecholamines will be restored. This article discusses the differential diagnosis of metabolic acidosis and presents a scheme for identifying the underlying cause of acidosis by using laboratory tests that are available

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Hyperosmolar Hyperglycemic State HHS Coma

By Dr. Ahmed Hafez

Hyperosmolar hyperglycemic state is a life-threatening emergency manifested by marked elevation of blood glucose and hyperosmolarity with little or no ketosis. Although there are multiple precipitating causes, underlying infections are the most common. Other causes include certain medications, nonadherence to therapy, undiagnosed diabetes mellitus, substance abuse, and coexisting disease. In children and adolescents, hyperosmolar hyperglycemic state is often present when type 2 diabetes is diagnosed. Physical findings include profound dehydration and neurologic symptoms ranging from lethargy to coma. Treatment begins with intensive monitoring of the patient and laboratory values, especially glucose, sodium, and potassium levels. Vigorous correction of dehydration is

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Cerebral coma

By Dr. Ahmed Hafez

What Is a Coma? A coma is a prolonged state of unconsciousness. During a coma, a person is unresponsive to their environment. The person is alive and looks like they are sleeping. However, unlike in a deep sleep, the person cannot be awakened by any stimulation, including pain. A coma is a prolonged state of unconsciousness. It is caused by an injury to the brain that can be due to increased pressure, bleeding, loss of oxygen, or buildup of toxins. The injury can be temporary and reversible but can also be permanent and lead to death. Coma Causes A coma

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Uremic Encephalopathy

By Dr. Ahmed Hafez

Practice Essentials Uremic encephalopathy is an organic brain disorder. It develops in patients with acute kidney injury or chronic kidney disease, usually when the estimated glomerular filtration rate (eGFR) falls and remains below 15 mL/min.  Manifestations of this syndrome vary from mild symptoms (eg, lassitude, fatigue) to severe signs (eg, seizures, coma). Severity and progression depend on the rate of decline in kidney function; thus, symptoms are usually worse in patients with acute kidney injury. Prompt identification of uremia as the cause of encephalopathy is essential because symptoms are readily reversible following initiation of dialysis. Pathophysiology Uremic encephalopathy has a

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