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Flashcards in Volume 4, Module 1 Deck (4)
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1

how does AKA (alcoholic ketoacidosis) occur?

multifactorial;

1. malnourished = low glycogen stores
2. increased lipolysis = poor nutritional intake, low insulin levels, increased sympathetic nervous system activity from decreasing alcohol levels
3. inhibited hepatic gluconeogenesis

2

- metabolism of ethanol by acetaldehyde dehydrogenase (ADH) = decrease in oxidized nicotinamide adenine dinucleotide (NAD+) to nicotinamide adenine dinucleotide hydride (NADH)

- increased NADH/NAD+ ratio = inhibited hepatic gluconeogenesis and production of β-hydroxybutyrate from acetoacetate

- also lactate forms from pyruvate

AKA metabolism

3

constellation of features c/w propofol infusion syndrome (PRIS)

- metabolic acidosis
- hypotension
- bradycardia
- fever
- AKI
- rhabdomyolysis
- RBBB

4

other findings that can occur w/ PRIS

- acute fatty liver
- hypertriglyceridemia
- precordial ST segment elevations