Correct!

3. Metformin-associated lactic acidosis

Type-B lactic acidosis occurs when no clinical evidence of poor tissue perfusion or poor oxygenation exists. He had a normal blood pressure and his ScvO2 = 79%.  We made tentative diagnoses of acute obstructive renal failure with dehydration leading to buildup of metformin and subsequent metformin-induced lactic acidosis, and likely starvation ketoacidosis.  Two articles describing transient blindness due to MALA were identified in the medical literature (1,2).

Which of the following is (are) true regarding therapy for MALA? (click on correct answer to move to next panel)

1. Hemodialysis should be performed as soon as possible for MALA
2. Sodium bicarbonate should be given immediately for MALA
3. There is no therapy proven to improve survival in MALA
4. 1 + 3
5. All of the above

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