GOLDMARK is
the new MUD PILES
A new mnemonic
has been created in the last few years for anion gap acidosis.
Oxoproline
L- lactate
D-lactate
Methanol
Aspirin
Renal failure
Ketoacidosis
Two popular mnemonics were often used to remember the major
causes of the high-gap metabolic acidoses. The first is KUSMALE which
represents Ketoacidosis, Uremia, Salicylate poisoning, Methanol, Aldehyde (paraldehyde),
Lactate, and Ethylene glycol.
The second is MUD PILES( most popular), spells out Methanol,
Uremia, Diabetic ketoacidosis, Paraldehyde, Iron (and Isoniazid), Lactate, Ethylene glycol,
and Salicylate.
Newer causes: D-lactate: seen with short gut syndrome(
especially after sugary drinks), diabetes can lead to d-lactate as well. Other new
causes is pyroglutamic acid ( oxoproline) seen with chronic Tylenol use.
Finally, propylene glycol infusion that is usually found in lorazepam, phenobarb
and banana bags.
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