SlideShare uma empresa Scribd logo
1 de 32
Interesting Case Conference
THE CASE ,[object Object],[object Object],[object Object],[object Object]
THE CASE ,[object Object]
THE ANION GAP
THE ANION GAP ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
KETOACIDOSIS
KETOACIDOSIS
KETOACIDOSIS
KETOACIDOSIS
KETOACIDOSIS
LACTIC ACIDOSIS
LACTIC ACIDOSIS
Increased lactate production ,[object Object],[object Object],[object Object],[object Object]
Increased lactate production ,[object Object],[object Object],[object Object],[object Object]
Increased lactate production ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Increased lactate production ,[object Object],[object Object],[object Object],[object Object],[object Object]
Primary decrease in lactate utilization ,[object Object],[object Object],[object Object]
Mechanism uncertain ,[object Object],[object Object],[object Object],[object Object],[object Object]
UREMIA
TOXINS
TOXINS
Toxins Isopropanol is primarily metabolized via alcohol dehydrogenase to acetone
TOXINS
TOXINS
Clinical course in acute ethylene glycol intoxication  ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Clinical course in acute ethylene glycol intoxication 12 to 24 hours  Cardiovascular  Mild hypertension, tachycardia, and shock      Pulmonary  Tachypnea adult respiratory distress syndrome pulmonary edema pneumonitis      Metabolic  Metabolic acidosis with elevated anion gap  decreased osmolal gap possible tetany from hypocalcemia, and hyperventilation
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
TOXINS
TOXINS
TOXINS
TOXINS
Conclusion ,[object Object],[object Object],[object Object]

Mais conteúdo relacionado

Mais procurados

ANAESTHESIA-INTRAVENOUS
ANAESTHESIA-INTRAVENOUSANAESTHESIA-INTRAVENOUS
ANAESTHESIA-INTRAVENOUSshrinathraman
 
Fluid responsiveness - an ICU phoenix
Fluid responsiveness - an ICU phoenixFluid responsiveness - an ICU phoenix
Fluid responsiveness - an ICU phoenixNIICS
 
Resp failure talk 9 10 bipap and hfnc emphasis
Resp failure talk 9 10  bipap and hfnc emphasisResp failure talk 9 10  bipap and hfnc emphasis
Resp failure talk 9 10 bipap and hfnc emphasisStevenP302
 
Inhalational anaesthetics
Inhalational anaestheticsInhalational anaesthetics
Inhalational anaestheticsJinijazz93
 
Supraglottic airway device
Supraglottic airway deviceSupraglottic airway device
Supraglottic airway deviceDebojyoti Dutta
 
Post dural puncture headache
Post dural puncture headachePost dural puncture headache
Post dural puncture headacheKIMS
 
Femoral line
Femoral line Femoral line
Femoral line EM OMSB
 
High flow nasal cannula
High flow nasal cannulaHigh flow nasal cannula
High flow nasal cannulaSCGH ED CME
 
01 capnography the new standard of care
01 capnography  the new standard of care01 capnography  the new standard of care
01 capnography the new standard of careDang Thanh Tuan
 
difficult weaning from Mechanical ventilator
 difficult weaning from Mechanical ventilator difficult weaning from Mechanical ventilator
difficult weaning from Mechanical ventilatorDr.Tarek Sabry
 
Anesthetic medications
Anesthetic medicationsAnesthetic medications
Anesthetic medicationsAyub Abdi
 
Capnography
CapnographyCapnography
Capnographylarryide
 

Mais procurados (20)

ANAESTHESIA-INTRAVENOUS
ANAESTHESIA-INTRAVENOUSANAESTHESIA-INTRAVENOUS
ANAESTHESIA-INTRAVENOUS
 
03 capnography
03 capnography03 capnography
03 capnography
 
Vaporizers
VaporizersVaporizers
Vaporizers
 
Stylets in anesthesia
Stylets in anesthesiaStylets in anesthesia
Stylets in anesthesia
 
Fluid responsiveness - an ICU phoenix
Fluid responsiveness - an ICU phoenixFluid responsiveness - an ICU phoenix
Fluid responsiveness - an ICU phoenix
 
Resp failure talk 9 10 bipap and hfnc emphasis
Resp failure talk 9 10  bipap and hfnc emphasisResp failure talk 9 10  bipap and hfnc emphasis
Resp failure talk 9 10 bipap and hfnc emphasis
 
Inhalational anaesthetics
Inhalational anaestheticsInhalational anaesthetics
Inhalational anaesthetics
 
Supraglottic airway device
Supraglottic airway deviceSupraglottic airway device
Supraglottic airway device
 
Post dural puncture headache
Post dural puncture headachePost dural puncture headache
Post dural puncture headache
 
Femoral line
Femoral line Femoral line
Femoral line
 
High flow nasal cannula
High flow nasal cannulaHigh flow nasal cannula
High flow nasal cannula
 
01 capnography the new standard of care
01 capnography  the new standard of care01 capnography  the new standard of care
01 capnography the new standard of care
 
difficult weaning from Mechanical ventilator
 difficult weaning from Mechanical ventilator difficult weaning from Mechanical ventilator
difficult weaning from Mechanical ventilator
 
Sickle cell ppt
Sickle cell pptSickle cell ppt
Sickle cell ppt
 
Anesthetic medications
Anesthetic medicationsAnesthetic medications
Anesthetic medications
 
Capnography
CapnographyCapnography
Capnography
 
Et co2
Et co2Et co2
Et co2
 
Ketamine
KetamineKetamine
Ketamine
 
Anatomy of the ventilator
Anatomy of the ventilatorAnatomy of the ventilator
Anatomy of the ventilator
 
Status asthmaticus
Status asthmaticusStatus asthmaticus
Status asthmaticus
 

Destaque

Friedreich ataxia case pres by dr adeel
Friedreich ataxia case pres by dr adeelFriedreich ataxia case pres by dr adeel
Friedreich ataxia case pres by dr adeelWest Medicine Ward
 
Friedreich’s Ataxia
Friedreich’s AtaxiaFriedreich’s Ataxia
Friedreich’s Ataxialiptontea1995
 
An approach to a child with abnormal movement
An approach to a child with abnormal movementAn approach to a child with abnormal movement
An approach to a child with abnormal movementSunil Agrawal
 
Friedreich's ataxia
Friedreich's ataxiaFriedreich's ataxia
Friedreich's ataxiazubair314
 
03 01-06 approach to ataxia
03 01-06 approach to ataxia03 01-06 approach to ataxia
03 01-06 approach to ataxiaAndrea Pardo
 
Renal tubular acidosis and other causes of Normal anion gap Metabolic acidosis
Renal tubular acidosis and other causes of Normal anion gap Metabolic acidosisRenal tubular acidosis and other causes of Normal anion gap Metabolic acidosis
Renal tubular acidosis and other causes of Normal anion gap Metabolic acidosisJagjit Khosla
 

Destaque (13)

Anion gap
Anion gapAnion gap
Anion gap
 
Anion gap
Anion gapAnion gap
Anion gap
 
Case record...Friedreich ataxia
Case record...Friedreich ataxiaCase record...Friedreich ataxia
Case record...Friedreich ataxia
 
Friedreich ataxia case pres by dr adeel
Friedreich ataxia case pres by dr adeelFriedreich ataxia case pres by dr adeel
Friedreich ataxia case pres by dr adeel
 
Baron coburg ppt Case Study and all
Baron coburg ppt Case Study and allBaron coburg ppt Case Study and all
Baron coburg ppt Case Study and all
 
Lactic Acidosis
Lactic AcidosisLactic Acidosis
Lactic Acidosis
 
Friedreich’s Ataxia
Friedreich’s AtaxiaFriedreich’s Ataxia
Friedreich’s Ataxia
 
An approach to a child with abnormal movement
An approach to a child with abnormal movementAn approach to a child with abnormal movement
An approach to a child with abnormal movement
 
Anión gap
Anión gapAnión gap
Anión gap
 
Ataxia yash final
Ataxia yash finalAtaxia yash final
Ataxia yash final
 
Friedreich's ataxia
Friedreich's ataxiaFriedreich's ataxia
Friedreich's ataxia
 
03 01-06 approach to ataxia
03 01-06 approach to ataxia03 01-06 approach to ataxia
03 01-06 approach to ataxia
 
Renal tubular acidosis and other causes of Normal anion gap Metabolic acidosis
Renal tubular acidosis and other causes of Normal anion gap Metabolic acidosisRenal tubular acidosis and other causes of Normal anion gap Metabolic acidosis
Renal tubular acidosis and other causes of Normal anion gap Metabolic acidosis
 

Semelhante a Gap Acidosis

Fluid and electrolyte imbalance
Fluid and electrolyte imbalanceFluid and electrolyte imbalance
Fluid and electrolyte imbalancefrank jc
 
Body electrolytes.pdf
Body electrolytes.pdfBody electrolytes.pdf
Body electrolytes.pdfABSammad
 
Metabolic complication of peritoneal dialysis
Metabolic complication of peritoneal dialysisMetabolic complication of peritoneal dialysis
Metabolic complication of peritoneal dialysisIPMS- KMU KPK PAKISTAN
 
Liver failure by dr magdi sasi 2015
Liver failure by dr magdi sasi 2015Liver failure by dr magdi sasi 2015
Liver failure by dr magdi sasi 2015cardilogy
 
inborn error of metabolism
inborn error of metabolisminborn error of metabolism
inborn error of metabolismzahid mehmood
 
Acid_base_balance_disorders.pptx
Acid_base_balance_disorders.pptxAcid_base_balance_disorders.pptx
Acid_base_balance_disorders.pptxNeha Verma
 
Acid Base disorders.ppt
Acid Base disorders.pptAcid Base disorders.ppt
Acid Base disorders.pptssuser0622881
 
iap-ahmedabad-inborn error of metabolism
iap-ahmedabad-inborn error of metabolismiap-ahmedabad-inborn error of metabolism
iap-ahmedabad-inborn error of metabolismNilu Panch
 
Organic Acidemias Didactic Bb Day1 3 Jh
Organic Acidemias Didactic Bb Day1 3 JhOrganic Acidemias Didactic Bb Day1 3 Jh
Organic Acidemias Didactic Bb Day1 3 JhSIMD
 
alchol electro. by dr agho.pptx
alchol electro. by dr agho.pptxalchol electro. by dr agho.pptx
alchol electro. by dr agho.pptxagho john
 
Abg intepretation case scenario
Abg  intepretation case scenarioAbg  intepretation case scenario
Abg intepretation case scenarioKamal Mergani
 
Hyperemesis gravidarum
Hyperemesis gravidarumHyperemesis gravidarum
Hyperemesis gravidarumpriya saxena
 
approach to inborn error of metabolism dr.mounika
approach to inborn error of metabolism  dr.mounikaapproach to inborn error of metabolism  dr.mounika
approach to inborn error of metabolism dr.mounikaDr Praman Kushwah
 
Nephrotic syndrome final
Nephrotic syndrome finalNephrotic syndrome final
Nephrotic syndrome finalakilav99
 

Semelhante a Gap Acidosis (20)

Fluid and electrolyte imbalance
Fluid and electrolyte imbalanceFluid and electrolyte imbalance
Fluid and electrolyte imbalance
 
Body electrolytes.pdf
Body electrolytes.pdfBody electrolytes.pdf
Body electrolytes.pdf
 
Metabolic complication of peritoneal dialysis
Metabolic complication of peritoneal dialysisMetabolic complication of peritoneal dialysis
Metabolic complication of peritoneal dialysis
 
Liver failure by dr magdi sasi 2015
Liver failure by dr magdi sasi 2015Liver failure by dr magdi sasi 2015
Liver failure by dr magdi sasi 2015
 
inborn error of metabolism
inborn error of metabolisminborn error of metabolism
inborn error of metabolism
 
La2009
La2009La2009
La2009
 
Acid_base_balance_disorders.pptx
Acid_base_balance_disorders.pptxAcid_base_balance_disorders.pptx
Acid_base_balance_disorders.pptx
 
Acid Base disorders.ppt
Acid Base disorders.pptAcid Base disorders.ppt
Acid Base disorders.ppt
 
Iem 2
Iem 2Iem 2
Iem 2
 
iap-ahmedabad-inborn error of metabolism
iap-ahmedabad-inborn error of metabolismiap-ahmedabad-inborn error of metabolism
iap-ahmedabad-inborn error of metabolism
 
Organic Acidemias Didactic Bb Day1 3 Jh
Organic Acidemias Didactic Bb Day1 3 JhOrganic Acidemias Didactic Bb Day1 3 Jh
Organic Acidemias Didactic Bb Day1 3 Jh
 
alchol electro. by dr agho.pptx
alchol electro. by dr agho.pptxalchol electro. by dr agho.pptx
alchol electro. by dr agho.pptx
 
Abg intepretation case scenario
Abg  intepretation case scenarioAbg  intepretation case scenario
Abg intepretation case scenario
 
Quizlet-inborn errors
Quizlet-inborn errorsQuizlet-inborn errors
Quizlet-inborn errors
 
Hyperemesis gravidarum
Hyperemesis gravidarumHyperemesis gravidarum
Hyperemesis gravidarum
 
approach to inborn error of metabolism dr.mounika
approach to inborn error of metabolism  dr.mounikaapproach to inborn error of metabolism  dr.mounika
approach to inborn error of metabolism dr.mounika
 
Nephrotic syndrome final
Nephrotic syndrome finalNephrotic syndrome final
Nephrotic syndrome final
 
Seco dka
Seco dkaSeco dka
Seco dka
 
Ethanol toxicity
Ethanol toxicityEthanol toxicity
Ethanol toxicity
 
Lactate by jack.
Lactate by jack.Lactate by jack.
Lactate by jack.
 

Mais de Joel Topf

Hyperkalemia, an update
Hyperkalemia, an updateHyperkalemia, an update
Hyperkalemia, an updateJoel Topf
 
Diabetic kidney disease
Diabetic kidney diseaseDiabetic kidney disease
Diabetic kidney diseaseJoel Topf
 
Low anion gap
Low anion gapLow anion gap
Low anion gapJoel Topf
 
Herbal toxins grand rounds feb 2014
Herbal toxins grand rounds feb 2014Herbal toxins grand rounds feb 2014
Herbal toxins grand rounds feb 2014Joel Topf
 
Acute Kidney Injury 2013
Acute Kidney Injury 2013Acute Kidney Injury 2013
Acute Kidney Injury 2013Joel Topf
 
Prescribing an app
Prescribing an appPrescribing an app
Prescribing an appJoel Topf
 
Creatine supplements
Creatine supplementsCreatine supplements
Creatine supplementsJoel Topf
 
Social Media in Health Care
Social Media in Health CareSocial Media in Health Care
Social Media in Health CareJoel Topf
 
Imaging in Acute Kidney Injury, how not to harm patients
Imaging in Acute Kidney Injury, how not to harm patientsImaging in Acute Kidney Injury, how not to harm patients
Imaging in Acute Kidney Injury, how not to harm patientsJoel Topf
 
AKI Lecture 2010
AKI Lecture 2010AKI Lecture 2010
AKI Lecture 2010Joel Topf
 
Uric Acid, Fructose and Hypertension
Uric Acid, Fructose and HypertensionUric Acid, Fructose and Hypertension
Uric Acid, Fructose and HypertensionJoel Topf
 
Hyponatremia
HyponatremiaHyponatremia
HyponatremiaJoel Topf
 
Diabetic Nephropathy 2009
Diabetic Nephropathy 2009Diabetic Nephropathy 2009
Diabetic Nephropathy 2009Joel Topf
 
Electrolyte Free Water Clearance
Electrolyte Free Water ClearanceElectrolyte Free Water Clearance
Electrolyte Free Water ClearanceJoel Topf
 
The Two Faces of Geriatric Kidney Disease
The Two Faces of Geriatric Kidney DiseaseThe Two Faces of Geriatric Kidney Disease
The Two Faces of Geriatric Kidney DiseaseJoel Topf
 
Whats New In Potassium
Whats New In PotassiumWhats New In Potassium
Whats New In PotassiumJoel Topf
 
Lead Time Bias
Lead Time BiasLead Time Bias
Lead Time BiasJoel Topf
 
Electrolyte Vignette
Electrolyte VignetteElectrolyte Vignette
Electrolyte VignetteJoel Topf
 
The Kidney and HIV
The Kidney and HIVThe Kidney and HIV
The Kidney and HIVJoel Topf
 

Mais de Joel Topf (20)

Hyperkalemia, an update
Hyperkalemia, an updateHyperkalemia, an update
Hyperkalemia, an update
 
Diabetic kidney disease
Diabetic kidney diseaseDiabetic kidney disease
Diabetic kidney disease
 
Low anion gap
Low anion gapLow anion gap
Low anion gap
 
Herbal toxins grand rounds feb 2014
Herbal toxins grand rounds feb 2014Herbal toxins grand rounds feb 2014
Herbal toxins grand rounds feb 2014
 
Acute Kidney Injury 2013
Acute Kidney Injury 2013Acute Kidney Injury 2013
Acute Kidney Injury 2013
 
Prescribing an app
Prescribing an appPrescribing an app
Prescribing an app
 
Creatine supplements
Creatine supplementsCreatine supplements
Creatine supplements
 
Social Media in Health Care
Social Media in Health CareSocial Media in Health Care
Social Media in Health Care
 
Imaging in Acute Kidney Injury, how not to harm patients
Imaging in Acute Kidney Injury, how not to harm patientsImaging in Acute Kidney Injury, how not to harm patients
Imaging in Acute Kidney Injury, how not to harm patients
 
AKI Lecture 2010
AKI Lecture 2010AKI Lecture 2010
AKI Lecture 2010
 
Uric Acid, Fructose and Hypertension
Uric Acid, Fructose and HypertensionUric Acid, Fructose and Hypertension
Uric Acid, Fructose and Hypertension
 
Hyponatremia
HyponatremiaHyponatremia
Hyponatremia
 
Diabetic Nephropathy 2009
Diabetic Nephropathy 2009Diabetic Nephropathy 2009
Diabetic Nephropathy 2009
 
Osmolar Gap
Osmolar GapOsmolar Gap
Osmolar Gap
 
Electrolyte Free Water Clearance
Electrolyte Free Water ClearanceElectrolyte Free Water Clearance
Electrolyte Free Water Clearance
 
The Two Faces of Geriatric Kidney Disease
The Two Faces of Geriatric Kidney DiseaseThe Two Faces of Geriatric Kidney Disease
The Two Faces of Geriatric Kidney Disease
 
Whats New In Potassium
Whats New In PotassiumWhats New In Potassium
Whats New In Potassium
 
Lead Time Bias
Lead Time BiasLead Time Bias
Lead Time Bias
 
Electrolyte Vignette
Electrolyte VignetteElectrolyte Vignette
Electrolyte Vignette
 
The Kidney and HIV
The Kidney and HIVThe Kidney and HIV
The Kidney and HIV
 

Último

Call Girls in Delhi Triveni Complex Escort Service(🔝))/WhatsApp 97111⇛47426
Call Girls in Delhi Triveni Complex Escort Service(🔝))/WhatsApp 97111⇛47426Call Girls in Delhi Triveni Complex Escort Service(🔝))/WhatsApp 97111⇛47426
Call Girls in Delhi Triveni Complex Escort Service(🔝))/WhatsApp 97111⇛47426jennyeacort
 
Top Rated Hyderabad Call Girls Erragadda ⟟ 9332606886 ⟟ Call Me For Genuine ...
Top Rated  Hyderabad Call Girls Erragadda ⟟ 9332606886 ⟟ Call Me For Genuine ...Top Rated  Hyderabad Call Girls Erragadda ⟟ 9332606886 ⟟ Call Me For Genuine ...
Top Rated Hyderabad Call Girls Erragadda ⟟ 9332606886 ⟟ Call Me For Genuine ...chandars293
 
Call Girl in Indore 8827247818 {LowPrice} ❤️ (ahana) Indore Call Girls * UPA...
Call Girl in Indore 8827247818 {LowPrice} ❤️ (ahana) Indore Call Girls  * UPA...Call Girl in Indore 8827247818 {LowPrice} ❤️ (ahana) Indore Call Girls  * UPA...
Call Girl in Indore 8827247818 {LowPrice} ❤️ (ahana) Indore Call Girls * UPA...mahaiklolahd
 
Model Call Girls In Chennai WhatsApp Booking 7427069034 call girl service 24 ...
Model Call Girls In Chennai WhatsApp Booking 7427069034 call girl service 24 ...Model Call Girls In Chennai WhatsApp Booking 7427069034 call girl service 24 ...
Model Call Girls In Chennai WhatsApp Booking 7427069034 call girl service 24 ...hotbabesbook
 
Call Girls Vasai Virar Just Call 9630942363 Top Class Call Girl Service Avail...
Call Girls Vasai Virar Just Call 9630942363 Top Class Call Girl Service Avail...Call Girls Vasai Virar Just Call 9630942363 Top Class Call Girl Service Avail...
Call Girls Vasai Virar Just Call 9630942363 Top Class Call Girl Service Avail...GENUINE ESCORT AGENCY
 
Call Girl In Pune 👉 Just CALL ME: 9352988975 💋 Call Out Call Both With High p...
Call Girl In Pune 👉 Just CALL ME: 9352988975 💋 Call Out Call Both With High p...Call Girl In Pune 👉 Just CALL ME: 9352988975 💋 Call Out Call Both With High p...
Call Girl In Pune 👉 Just CALL ME: 9352988975 💋 Call Out Call Both With High p...chetankumar9855
 
Trichy Call Girls Book Now 9630942363 Top Class Trichy Escort Service Available
Trichy Call Girls Book Now 9630942363 Top Class Trichy Escort Service AvailableTrichy Call Girls Book Now 9630942363 Top Class Trichy Escort Service Available
Trichy Call Girls Book Now 9630942363 Top Class Trichy Escort Service AvailableGENUINE ESCORT AGENCY
 
(Low Rate RASHMI ) Rate Of Call Girls Jaipur ❣ 8445551418 ❣ Elite Models & Ce...
(Low Rate RASHMI ) Rate Of Call Girls Jaipur ❣ 8445551418 ❣ Elite Models & Ce...(Low Rate RASHMI ) Rate Of Call Girls Jaipur ❣ 8445551418 ❣ Elite Models & Ce...
(Low Rate RASHMI ) Rate Of Call Girls Jaipur ❣ 8445551418 ❣ Elite Models & Ce...parulsinha
 
Top Quality Call Girl Service Kalyanpur 6378878445 Available Call Girls Any Time
Top Quality Call Girl Service Kalyanpur 6378878445 Available Call Girls Any TimeTop Quality Call Girl Service Kalyanpur 6378878445 Available Call Girls Any Time
Top Quality Call Girl Service Kalyanpur 6378878445 Available Call Girls Any TimeCall Girls Delhi
 
Premium Call Girls In Jaipur {8445551418} ❤️VVIP SEEMA Call Girl in Jaipur Ra...
Premium Call Girls In Jaipur {8445551418} ❤️VVIP SEEMA Call Girl in Jaipur Ra...Premium Call Girls In Jaipur {8445551418} ❤️VVIP SEEMA Call Girl in Jaipur Ra...
Premium Call Girls In Jaipur {8445551418} ❤️VVIP SEEMA Call Girl in Jaipur Ra...parulsinha
 
The Most Attractive Hyderabad Call Girls Kothapet 𖠋 9332606886 𖠋 Will You Mis...
The Most Attractive Hyderabad Call Girls Kothapet 𖠋 9332606886 𖠋 Will You Mis...The Most Attractive Hyderabad Call Girls Kothapet 𖠋 9332606886 𖠋 Will You Mis...
The Most Attractive Hyderabad Call Girls Kothapet 𖠋 9332606886 𖠋 Will You Mis...chandars293
 
Mumbai ] (Call Girls) in Mumbai 10k @ I'm VIP Independent Escorts Girls 98333...
Mumbai ] (Call Girls) in Mumbai 10k @ I'm VIP Independent Escorts Girls 98333...Mumbai ] (Call Girls) in Mumbai 10k @ I'm VIP Independent Escorts Girls 98333...
Mumbai ] (Call Girls) in Mumbai 10k @ I'm VIP Independent Escorts Girls 98333...Ishani Gupta
 
Coimbatore Call Girls in Thudiyalur : 7427069034 High Profile Model Escorts |...
Coimbatore Call Girls in Thudiyalur : 7427069034 High Profile Model Escorts |...Coimbatore Call Girls in Thudiyalur : 7427069034 High Profile Model Escorts |...
Coimbatore Call Girls in Thudiyalur : 7427069034 High Profile Model Escorts |...chennailover
 
Call Girls Rishikesh Just Call 9667172968 Top Class Call Girl Service Available
Call Girls Rishikesh Just Call 9667172968 Top Class Call Girl Service AvailableCall Girls Rishikesh Just Call 9667172968 Top Class Call Girl Service Available
Call Girls Rishikesh Just Call 9667172968 Top Class Call Girl Service Availableperfect solution
 
Saket * Call Girls in Delhi - Phone 9711199012 Escorts Service at 6k to 50k a...
Saket * Call Girls in Delhi - Phone 9711199012 Escorts Service at 6k to 50k a...Saket * Call Girls in Delhi - Phone 9711199012 Escorts Service at 6k to 50k a...
Saket * Call Girls in Delhi - Phone 9711199012 Escorts Service at 6k to 50k a...BhumiSaxena1
 
Call Girls Service Jaipur {9521753030 } ❤️VVIP BHAWNA Call Girl in Jaipur Raj...
Call Girls Service Jaipur {9521753030 } ❤️VVIP BHAWNA Call Girl in Jaipur Raj...Call Girls Service Jaipur {9521753030 } ❤️VVIP BHAWNA Call Girl in Jaipur Raj...
Call Girls Service Jaipur {9521753030 } ❤️VVIP BHAWNA Call Girl in Jaipur Raj...khalifaescort01
 
8980367676 Call Girls In Ahmedabad Escort Service Available 24×7 In Ahmedabad
8980367676 Call Girls In Ahmedabad Escort Service Available 24×7 In Ahmedabad8980367676 Call Girls In Ahmedabad Escort Service Available 24×7 In Ahmedabad
8980367676 Call Girls In Ahmedabad Escort Service Available 24×7 In AhmedabadGENUINE ESCORT AGENCY
 
Independent Call Girls Service Mohali Sector 116 | 6367187148 | Call Girl Ser...
Independent Call Girls Service Mohali Sector 116 | 6367187148 | Call Girl Ser...Independent Call Girls Service Mohali Sector 116 | 6367187148 | Call Girl Ser...
Independent Call Girls Service Mohali Sector 116 | 6367187148 | Call Girl Ser...karishmasinghjnh
 
Call Girls Madurai Just Call 9630942363 Top Class Call Girl Service Available
Call Girls Madurai Just Call 9630942363 Top Class Call Girl Service AvailableCall Girls Madurai Just Call 9630942363 Top Class Call Girl Service Available
Call Girls Madurai Just Call 9630942363 Top Class Call Girl Service AvailableGENUINE ESCORT AGENCY
 

Último (20)

Call Girls in Delhi Triveni Complex Escort Service(🔝))/WhatsApp 97111⇛47426
Call Girls in Delhi Triveni Complex Escort Service(🔝))/WhatsApp 97111⇛47426Call Girls in Delhi Triveni Complex Escort Service(🔝))/WhatsApp 97111⇛47426
Call Girls in Delhi Triveni Complex Escort Service(🔝))/WhatsApp 97111⇛47426
 
Top Rated Hyderabad Call Girls Erragadda ⟟ 9332606886 ⟟ Call Me For Genuine ...
Top Rated  Hyderabad Call Girls Erragadda ⟟ 9332606886 ⟟ Call Me For Genuine ...Top Rated  Hyderabad Call Girls Erragadda ⟟ 9332606886 ⟟ Call Me For Genuine ...
Top Rated Hyderabad Call Girls Erragadda ⟟ 9332606886 ⟟ Call Me For Genuine ...
 
Call Girl in Indore 8827247818 {LowPrice} ❤️ (ahana) Indore Call Girls * UPA...
Call Girl in Indore 8827247818 {LowPrice} ❤️ (ahana) Indore Call Girls  * UPA...Call Girl in Indore 8827247818 {LowPrice} ❤️ (ahana) Indore Call Girls  * UPA...
Call Girl in Indore 8827247818 {LowPrice} ❤️ (ahana) Indore Call Girls * UPA...
 
Model Call Girls In Chennai WhatsApp Booking 7427069034 call girl service 24 ...
Model Call Girls In Chennai WhatsApp Booking 7427069034 call girl service 24 ...Model Call Girls In Chennai WhatsApp Booking 7427069034 call girl service 24 ...
Model Call Girls In Chennai WhatsApp Booking 7427069034 call girl service 24 ...
 
Call Girls Vasai Virar Just Call 9630942363 Top Class Call Girl Service Avail...
Call Girls Vasai Virar Just Call 9630942363 Top Class Call Girl Service Avail...Call Girls Vasai Virar Just Call 9630942363 Top Class Call Girl Service Avail...
Call Girls Vasai Virar Just Call 9630942363 Top Class Call Girl Service Avail...
 
Call Girl In Pune 👉 Just CALL ME: 9352988975 💋 Call Out Call Both With High p...
Call Girl In Pune 👉 Just CALL ME: 9352988975 💋 Call Out Call Both With High p...Call Girl In Pune 👉 Just CALL ME: 9352988975 💋 Call Out Call Both With High p...
Call Girl In Pune 👉 Just CALL ME: 9352988975 💋 Call Out Call Both With High p...
 
Trichy Call Girls Book Now 9630942363 Top Class Trichy Escort Service Available
Trichy Call Girls Book Now 9630942363 Top Class Trichy Escort Service AvailableTrichy Call Girls Book Now 9630942363 Top Class Trichy Escort Service Available
Trichy Call Girls Book Now 9630942363 Top Class Trichy Escort Service Available
 
(Low Rate RASHMI ) Rate Of Call Girls Jaipur ❣ 8445551418 ❣ Elite Models & Ce...
(Low Rate RASHMI ) Rate Of Call Girls Jaipur ❣ 8445551418 ❣ Elite Models & Ce...(Low Rate RASHMI ) Rate Of Call Girls Jaipur ❣ 8445551418 ❣ Elite Models & Ce...
(Low Rate RASHMI ) Rate Of Call Girls Jaipur ❣ 8445551418 ❣ Elite Models & Ce...
 
Top Quality Call Girl Service Kalyanpur 6378878445 Available Call Girls Any Time
Top Quality Call Girl Service Kalyanpur 6378878445 Available Call Girls Any TimeTop Quality Call Girl Service Kalyanpur 6378878445 Available Call Girls Any Time
Top Quality Call Girl Service Kalyanpur 6378878445 Available Call Girls Any Time
 
Call Girls in Gagan Vihar (delhi) call me [🔝 9953056974 🔝] escort service 24X7
Call Girls in Gagan Vihar (delhi) call me [🔝  9953056974 🔝] escort service 24X7Call Girls in Gagan Vihar (delhi) call me [🔝  9953056974 🔝] escort service 24X7
Call Girls in Gagan Vihar (delhi) call me [🔝 9953056974 🔝] escort service 24X7
 
Premium Call Girls In Jaipur {8445551418} ❤️VVIP SEEMA Call Girl in Jaipur Ra...
Premium Call Girls In Jaipur {8445551418} ❤️VVIP SEEMA Call Girl in Jaipur Ra...Premium Call Girls In Jaipur {8445551418} ❤️VVIP SEEMA Call Girl in Jaipur Ra...
Premium Call Girls In Jaipur {8445551418} ❤️VVIP SEEMA Call Girl in Jaipur Ra...
 
The Most Attractive Hyderabad Call Girls Kothapet 𖠋 9332606886 𖠋 Will You Mis...
The Most Attractive Hyderabad Call Girls Kothapet 𖠋 9332606886 𖠋 Will You Mis...The Most Attractive Hyderabad Call Girls Kothapet 𖠋 9332606886 𖠋 Will You Mis...
The Most Attractive Hyderabad Call Girls Kothapet 𖠋 9332606886 𖠋 Will You Mis...
 
Mumbai ] (Call Girls) in Mumbai 10k @ I'm VIP Independent Escorts Girls 98333...
Mumbai ] (Call Girls) in Mumbai 10k @ I'm VIP Independent Escorts Girls 98333...Mumbai ] (Call Girls) in Mumbai 10k @ I'm VIP Independent Escorts Girls 98333...
Mumbai ] (Call Girls) in Mumbai 10k @ I'm VIP Independent Escorts Girls 98333...
 
Coimbatore Call Girls in Thudiyalur : 7427069034 High Profile Model Escorts |...
Coimbatore Call Girls in Thudiyalur : 7427069034 High Profile Model Escorts |...Coimbatore Call Girls in Thudiyalur : 7427069034 High Profile Model Escorts |...
Coimbatore Call Girls in Thudiyalur : 7427069034 High Profile Model Escorts |...
 
Call Girls Rishikesh Just Call 9667172968 Top Class Call Girl Service Available
Call Girls Rishikesh Just Call 9667172968 Top Class Call Girl Service AvailableCall Girls Rishikesh Just Call 9667172968 Top Class Call Girl Service Available
Call Girls Rishikesh Just Call 9667172968 Top Class Call Girl Service Available
 
Saket * Call Girls in Delhi - Phone 9711199012 Escorts Service at 6k to 50k a...
Saket * Call Girls in Delhi - Phone 9711199012 Escorts Service at 6k to 50k a...Saket * Call Girls in Delhi - Phone 9711199012 Escorts Service at 6k to 50k a...
Saket * Call Girls in Delhi - Phone 9711199012 Escorts Service at 6k to 50k a...
 
Call Girls Service Jaipur {9521753030 } ❤️VVIP BHAWNA Call Girl in Jaipur Raj...
Call Girls Service Jaipur {9521753030 } ❤️VVIP BHAWNA Call Girl in Jaipur Raj...Call Girls Service Jaipur {9521753030 } ❤️VVIP BHAWNA Call Girl in Jaipur Raj...
Call Girls Service Jaipur {9521753030 } ❤️VVIP BHAWNA Call Girl in Jaipur Raj...
 
8980367676 Call Girls In Ahmedabad Escort Service Available 24×7 In Ahmedabad
8980367676 Call Girls In Ahmedabad Escort Service Available 24×7 In Ahmedabad8980367676 Call Girls In Ahmedabad Escort Service Available 24×7 In Ahmedabad
8980367676 Call Girls In Ahmedabad Escort Service Available 24×7 In Ahmedabad
 
Independent Call Girls Service Mohali Sector 116 | 6367187148 | Call Girl Ser...
Independent Call Girls Service Mohali Sector 116 | 6367187148 | Call Girl Ser...Independent Call Girls Service Mohali Sector 116 | 6367187148 | Call Girl Ser...
Independent Call Girls Service Mohali Sector 116 | 6367187148 | Call Girl Ser...
 
Call Girls Madurai Just Call 9630942363 Top Class Call Girl Service Available
Call Girls Madurai Just Call 9630942363 Top Class Call Girl Service AvailableCall Girls Madurai Just Call 9630942363 Top Class Call Girl Service Available
Call Girls Madurai Just Call 9630942363 Top Class Call Girl Service Available
 

Gap Acidosis