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

Updated: Oct 10, 2018
  • 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: M-methanol; U-uremia; D-DKA, AKA; P-paraldehyde, phenformin; I-iron, isoniazid; L-lactic (ie, CO, cyanide); E-ethylene glycol; S-salicylates

  • DR. MAPLES: D-DKA; R-renal; M-methanol; A-alcoholic ketoacidosis; P-paraldehyde, phenformin; L-lactic (ie, CO, HCN); E-ethylene glycol; S-salicylates

  • SLUMPED (S-salicylate, L-lactate, U-uremia, M-methanol, P-paraldehyde, E-ethylene glycol, D-diabetes)

A more current mnemonic is GOLD MARK, which incorporates newly recognized forms of metabolic acidosis and eliminates P for paraldehyde as this is now rarely seen. [6]

  • GOLD MARK: G-Glycols (ethylene and propylene), O-Oxoproline, L-lactate, D-lactate, M-Methanol, A-Aspirin, R-Renal failure, and K-Ketoacidosis

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