title: Formerly obese, now thin and confused: the utility of mnemonics in the approach to altered mental status.
abstract: Altered mental status represents a common cause for admission to general medicine services. Often a significant workup ensues to define an underlying etiology. When a history of bariatric surgery with small bowel resection precedes the presentation, the differential diagnosis expands. We review a patient, having prior bariatric surgery and small bowel resection, who presents with altered mental status. After an extensive workup, she was diagnosed with a rare clinical problem, D-lactic acidosis. In presenting this case, we examine the use of mnemonics in medicine and how this can assist in solving clinical problems.
authors.affiliation: Department of Gastroenterology and Hepatology (CMB), University of Alabama, Birmingham, Alabama; Department of Internal Medicine (CSM), Tulane University, New Orleans, Louisiana; and Department of Internal Medicine (RMC), University of Alabama, Birmingham, Alabama.
authors.forename: Chad M
authors.initials: CM
authors.lastname: Burski
authors.forename: Chad S
authors.initials: CS
authors.lastname: Miller
authors.forename: Robert M
authors.initials: RM
authors.lastname: Centor
mesh_terms: D000140:Acidosis, Lactic / Q000150:complications* / Q000175:diagnosis*; D000328:Adult; D050110:Bariatric Surgery / Q000009:adverse effects; D003221:Confusion / Q000139:chemically induced*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007421:Intestine, Small / Q000601:surgery; D019344:Lactic Acid / Q000378:metabolism*; D008568:Memory; D017010:Reminder Systems
chemical_list: D019344:Lactic Acid