Lactic acidosis is common with:
**Core Concept**
Lactic acidosis is a type of metabolic acidosis characterized by an elevated level of lactate in the blood, which occurs due to an imbalance between lactate production and clearance. This condition can arise from various factors, including tissue hypoxia, mitochondrial dysfunction, and certain medications.
**Why the Correct Answer is Right**
Lactic acidosis is often associated with the use of metformin, a biguanide antidiabetic medication. Metformin acts by inhibiting complex 1 of the electron transport chain in the mitochondria, thereby reducing gluconeogenesis and increasing lactate production. However, in the setting of renal insufficiency or liver disease, metformin can accumulate to toxic levels, leading to lactic acidosis.
**Why Each Wrong Option is Incorrect**
**Option A:**
This option is incorrect because while beta-blockers can cause hypoglycemia, they are not directly associated with lactic acidosis.
**Option B:**
This option is incorrect because while NSAIDs can cause renal impairment and increase the risk of lactic acidosis, they are not the most direct cause of this condition.
**Option C:**
This option is incorrect because while corticosteroids can cause hyperglycemia, they are not directly associated with lactic acidosis.
**Clinical Pearl / High-Yield Fact**
It's essential to note that lactic acidosis can be a medical emergency, and prompt recognition and treatment are crucial to prevent morbidity and mortality. Metformin should be discontinued in patients with renal insufficiency or liver disease to prevent this condition.
**Correct Answer: B. NSAIDs can increase the risk of lactic acidosis, especially in patients with pre-existing kidney disease.**