Day #280 - Anion Gap Metabolic Acidosis in an Alcoholic

Today was great!

We talked about the approach to acute confusion.

Then we talked about alcohol withdrawl and the treatment thereof. An approach that seems "easy" to remember is to use CIWA-A hourly giving 15mg for CIWA-A 8 to 15 and 30mg for scores above 15. Diazepam or lorazepam can be substituted. Disorientation and hallucinosis can be treated with small doses of haloperidol (i.e. 2.5-5mg)

Then we talked about the differential diagnosis of anion gap metabolic acidosis and the fact that the osmolar gap can sometimes be normal in toxic alcohol poisoning.

Then we talked about the management of HONK/DKA.