What are the mnemonics used to recall the differential diagnoses of high anion gap acidosis?

Updated: Dec 08, 2020
  • Author: Christie P Thomas, MBBS, FRCP, FASN, FAHA; Chief Editor: Vecihi Batuman, MD, FASN  more...
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Several mnemonics are used to help recall of the differential diagnosis of high anion gap acidosis. Three are as follows:

  • MUDPILES: Methanol; uremia; diabetic ketoacidosis (DKA); paraldehyde, phenformin; iron, isoniazid; lactic (ie, carbon monoxide [CO], cyanide); ethylene glycol; salicylates

  • DR. MAPLES: DKA; renal; methanol; alcoholic ketoacidosis; paraldehyde, phenformin; lactic (ie, CO, HCN); ethylene glycol; salicylates

  • SLUMPED: Salicylate, lactate, uremia, methanol, paraldehyde, ethylene glycol, diabetes)

A more current mnemonic is GOLD MARK, which incorporates newly recognized forms of metabolic acidosis and eliminates P for paraldehyde as that is now rarely seen. [10]

  • GOLD MARK: Glycols (ethylene and propylene), oxoproline, lactate, D-lactate, methanol, aspirin, renal failure, ketoacidosis

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