Common causes of lactic acidosis include which combination?

• A. DKA, renal failure or sepsis
• B. Hyperkalemia
• C. Myocardial infarction
• D. Hypothyroidism

Answer: (A)

Lactic acidosis happens when lactate builds up from anaerobic metabolism or when the body can’t clear lactate effectively. Conditions that commonly push this process include poor tissue perfusion and metabolic stress, such as in diabetic ketoacidosis with dehydration, sepsis, and renal failure. In DKA, dehydration and hypoperfusion increase lactate production; sepsis causes widespread poor oxygen delivery and mitochondrial dysfunction, boosting lactate; renal failure impairs lactate clearance, allowing it to accumulate. This combination—DKA with renal failure or sepsis—fits the typical, commonly seen causes well. Hyperkalemia isn’t a driver of lactate production, myocardial infarction can cause lactate in the setting of severe ischemia but is not as typical a cause, and hypothyroidism does not usually lead to lactic acidosis.