Normal Anion Gap Metabolic Acidosis

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Serum Anion Gap: Its Uses And Limitations In Clinical Medicine

Abstract The serum anion gap, calculated from the electrolytes measured in the chemical laboratory, is defined as the sum of serum chloride and bicarbonate concentrations subtracted from the serum sodium concentration. This entity is used in the detection and analysis of acid-base disorders, assessment of quality control in the chemical laboratory, and detection of such disorders as multiple myeloma, bromide intoxication, and lithium intoxication. The normal value can vary widely, reflecting both differences in the methods that are used to measure its constituents and substantial interindividual variability. Low values most commonly indicate laboratory error or hypoalbuminemia but can denote the presence of a paraproteinemia or intoxication with lithium, bromide, or iodide. Elevated values most commonly indicate metabolic acidosis but can reflect laboratory error, metabolic alkalosis, hyperphosphatemia, or paraproteinemia. Metabolic acidosis can be divided into high anion and normal anion gap varieties, which can be present alone or concurrently. A presumed 1:1 stoichiometry between change in the serum anion gap (ΔAG) and change in the serum bicarbonate concentration (ΔHCO3−) h Continue reading >>

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  1. Phuzzmodiar

    I was just curious as to how you guys like to count your carbs. I read all kinds of posts to try and keep myself motivated, but I always wondered when someone would say that they have 20g of carbs a day if they meant total carbs or net carbs.
    What number do you personally like to hover around?

  2. bidnow

    Net carbs. I'm now averaging 31, but I shoot for 28. Occasional yogurt or cheap protein powder bump up my average.

  3. manateens

    I got the cheapest, nastiest protein powder I could at WalMart - chocoalte flavored, it's like 4 net a scoop, plus ~2 net from unsweetened unflavored almond milk (can't do water, sorry). It's pretty decent carb-wise, I think, unless you go for 2-3 scoops a day :/

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A lecture on the differential diagnosis of a normal anion gap metabolic acidosis, focusing on renal tubular acidosis, but also covering diarrhea, saline infusion, hyperkalemia, kidney failure, and ureteral diversion

Normal Anion Gap Metabolic Acidosis

Home | Critical Care Compendium | Normal Anion Gap Metabolic Acidosis Normal Anion Gap Metabolic Acidosis (NAGMA) HCO3 loss and replaced with Cl- -> anion gap normal if hyponatraemia is present the plasma [Cl-] may be normal despite the presence of a normal anion gap acidosis -> this could be considered a ‘relative hyperchloraemia’. Extras – RTA, ingestion of oral acidifying salts, recovery phase of DKA loss of bicarbonate with chloride replacement -> hyperchloraemic acidosis secretions into the large and small bowel are mostly alkaline with a bicarbonate level higher than that in plasma. some typical at risk clinical situations are: external drainage of pancreatic or biliary secretions (eg fistulas) this should be easily established by history normally 85% of filtered bicarbonate is reabsorbed in the proximal tubule and the remaining 15% is reabsorbed in the rest of the tubule in patients receiving acetazolamide (or other carbonic anhydrase inhibitors), proximal reabsorption of bicarbonate is decreased resulting in increased distal delivery and HCO3- appears in urine this results in a hyperchloraemic metabolic acidosis and is essentially a form of proximal renal tubular aci Continue reading >>

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  1. Shanell08

    High Blood Sugars with No Ketones

    So my boyfriend has had Type 1 Diabetes for over 10 years now and while having High Blood Sugars he has never had any ketones. Everytime he tests it is always negative. Even with a Blood Sugar of 500. What does this mean? What is his body using for fuel? Should I be alarmed? Thanks!

  2. hannahtan

    Interesting... perhaps your bf is still producing that tiny bit of insulin which is what that is keeping him from developing into DKA but not enough to regulate his bg?

  3. MarkM

    Originally Posted by Shanell08
    ... while having High Blood Sugars he has never had any ketones. Everytime he tests it is always negative. Even with a Blood Sugar of 500. What does this mean? What is his body using for fuel? Should I be alarmed? Thanks! It just means that there is enough circulating insulin for for the body's glucose requirements to be satisfied. Ketones are produced when fat or muscle are broken down. And large amounts of ketones are only produced if there is inadequate insulin for glucose to be used as fuel to keep the body ticking over.

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Acid-base Disorders

Content currently under development Acid-base disorders are a group of conditions characterized by changes in the concentration of hydrogen ions (H+) or bicarbonate (HCO3-), which lead to changes in the arterial blood pH. These conditions can be categorized as acidoses or alkaloses and have a respiratory or metabolic origin, depending on the cause of the imbalance. Diagnosis is made by arterial blood gas (ABG) interpretation. In the setting of metabolic acidosis, calculation of the anion gap is an important resource to narrow down the possible causes and reach a precise diagnosis. Treatment is based on identifying the underlying cause. Continue reading >>

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  1. Lauraa83

    The ones you use on the atkins diet?

  2. Mummyvicky

    I asked at Boots Pharmacy for a friend who was doing it, it was about £4 for 50 strips.

  3. Normsnockers

    Message withdrawn

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