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Normal Anion Gap Metabolic Acidosis Mnemonic

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Anion gap usmle - anion gap metabolic acidosis normal anion gap metabolic acidosis

Normal Anion Gap Acidosis

Terry W. Hensle, Erica H. Lambert, in Pediatric Urology , 2010 Nonanion gap acidosis occurs in situations in which HCO3 is lost from the kidney or the gastrointestinal tract or both. When this occurs, Cl (along with Na+) is reabsorbed to replace the HCO3; this leads to the hyperchloremia, which leaves the anion gap in normal range.10 Diarrhea causes a hyperchloremic, hypokalemic metabolic acidosis. Treatment depends on the severity of the acidosis incurred. In mild to moderate acidosis (pH >7.2), fluid and electrolyte replacement is often all that is required. Once adequate renal perfusion is restored, excess H+ can be excreted efficiently, restoring the pH to normal. In severe acidosis (pH <7.2), the addition of intravenous bicarbonate may be needed to correct the metabolic deficit. Before bicarbonate is administered, a serum potassium level should be obtained. The addition of bicarbonate can worsen hypokalemia, leading to neuromuscular complications. Hyperchloremic acidosis also occurs with renal insufficiency and renal tubular acidosis.9,20 Katherine Ahn Jin, in Comprehensive Pediatric Hospital Medicine , 2007 As in any condition, the first priority in management is stabilizing Continue reading >>

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  1. tk421

    Sorry if this doesn't belong in this part of the forum, but it seems better here than the other places in the forum.
    I am having trouble finding a solid answer to this. Everywhere I look online tells me something different. I see some say around 50 mg/dl which I would think is totally hypoglycemic. So I don’t really believe that. I see others saying as long as you are below about 97 mg/dl. I see others that say in the 80s. Some say other things. I just want a straight answer. So I need some advice from a successful keto person.
    What is proper blood glucose levels for someone who is in ketosis? I got this blood glucose monitor and I think it may be defective or just a crappy brand. Yesterday my fasting blood glucose (after a 14 hour fast) was 83 mg/dl. Today (again after a 14 hour fast) was 97. I couldn’t believe it so I took my blood glucose again and it said 92. Then I ate exactly 3 pieces of bacon and a piece of cheese, and two hours later my blood glucose was 102. I thought WTF, so I immediately took it again and it said 109.
    So maybe I have a defective monitor (the Nova Max Plus), but regardless, there is probably at least a little bit of truth to it. But I seriously eat 25 grams or less of carbs per day. Usually less.
    Could someone please explain glucose levels to me in regards to ketosis.

  2. JBean

    In the absence of dietary carbohydrates, your body will break down fats and proteins to maintain your blood glucose in the normal range. Here's an explanation:
    https://en.m.wikipedia.org/wiki/Gluconeogenesis

  3. tk421

    Originally posted by JBean
    In the absence of dietary carbohydrates, your body will break down fats and proteins to maintain your blood glucose in the normal range. Here's an explanation:
    https://en.m.wikipedia.org/wiki/Gluconeogenesis Very interesting. Thanks for the info, that helps me a lot!!
    Cheers

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What is BASAL METABOLIC RATE? What does BASAL METABOLIC RATE mean? BASAL METABOLIC RATE meaning - BASAL METABOLIC RATE definition - BASAL METABOLIC RATE explanation. Source: Wikipedia.org article, adapted under https://creativecommons.org/licenses/... license. Basal metabolic rate (BMR) is the minimal rate of energy expenditure per unit time by endothermic animals at rest. It is reported in energy units per unit time ranging from watt (joule/second) to ml O2/min or joule per hour per kg body mass J/(hkg)). Proper measurement requires a strict set of criteria be met. These criteria include being in a physically and psychologically undisturbed state, in a thermally neutral environment, while in the post-absorptive state (i.e., not actively digesting food). In bradymetabolic animals, such as fish and reptiles, the equivalent term standard metabolic rate (SMR) is used. It follows the same criteria as BMR, but requires the documentation of the temperature at which the metabolic rate was measured. This makes BMR a variant of standard metabolic rate measurement that excludes the temperature data, a practice that has led to problems in defining "standard" rates of metabolism for many mammals. Metabolism comprises the processes that the body needs to function. Basal metabolic rate is the amount of energy expressed in calories that a person needs to keep the body functioning at rest. Some of those processes are breathing, blood circulation, controlling body temperature, cell growth, brain and nerve function, and contraction of muscles. Basal metabolic rate (BMR) affects the rate that a person burns calories and ultimately whether that individual maintains, gains, or loses weight. The basal metabolic rate accounts for about 60 to 75% of the daily calorie expenditure by individuals. It is influenced by several factors. BMR typically declines by 12% per decade after age 20, mostly due to loss of fat-free mass, although the variability between individuals is high. The body's generation of heat is known as thermogenesis and it can be measured to determine the amount of energy expended. BMR generally decreases with age and with the decrease in lean body mass (as may happen with aging). Increasing muscle mass has the effect of increasing BMR. Aerobic (resistance) fitness level, a product of cardiovascular exercise, while previously thought to have effect on BMR, has been shown in the 1990s not to correlate with BMR when adjusted for fat-free body mass. But anaerobic exercise does increase resting energy consumption (see "aerobic vs. anaerobic exercise"). Illness, previously consumed food and beverages, environmental temperature, and stress levels can affect one's overall energy expenditure as well as one's BMR. BMR is measured under very restrictive circumstances when a person is awake. An accurate BMR measurement requires that the person's sympathetic nervous system not be stimulated, a condition which requires complete rest. A more common measurement, which uses less strict criteria, is resting metabolic rate (RMR).

Metabolic Acidosis

Diabetic Ketoacidosis (DKA), Alcohol ic ketoacidosis or starvation ketosis Paraldehyde, Phenformin (neither used in U.S. now) Propofol Infusion Syndrome has been proposed as a replacement in mnemonic Salicylate s (do not miss Chronic Salicylate Poisoning ) IV. Causes: Metabolic Acidosis and Normal Anion Gap (Hyperchloremia) Renal Tubular Acidosis (proximal or distal) V. Causes: Metabolic Acidosis and Elevated Osmolal Gap PaCO2 drops 1.2 mmHg per 1 meq/L bicarbonate fall Calculated PaCO2 = 1.5 x HCO3 + 8 (+/- 2) Useful in High Anion Gap Metabolic Acidosis Measured PaCO2 discrepancy: respiratory disorder Investigate normal Anion Gap Metabolic Acidosis Elevated in normal Anion Gap Metabolic Acidosis VII. Labs: Consider in Metabolic Acidosis with Increased Anion Gap Basic chemistry panel as above ( Serum Glucose , Blood Urea Nitrogen ) Rutecki (Dec 1997) Consultant, p. 3067-74 Images: Related links to external sites (from Bing) These images are a random sampling from a Bing search on the term "Metabolic Acidosis." Click on the image (or right click) to open the source website in a new browser window. Search Bing for all related images Related Studies (from Trip Database) Open in New W Continue reading >>

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  1. Keith Burwood McFarland

    There's actually some science on this and while it goes back and forth as to how good or how bad marijuana is for your lungs, generally speaking, smoking marijuana is about one-tenth as bad for your lungs as smoking cigarettes—this has more to do with the additives in cigarettes then it does to do with smoking either one of these untreated. I suppose that you were to smoke tobacco in its natural state without any additives, the effects might be similar, but since cigarettes are treated, and marijuana really isn't, cigarettes are far worse for you than marijuana. The best thing to do with marijuana use you some kind of vaporizing device, something that heats it to the temperature necessary to release the THC component without burning the actual fiber. You'll reduce the effects to your lungs even more that way.

  2. Christopher Del Monte

    No evidence suggests that this is the case. Though Cannabis is still being heavily researched, no conclusion has yielded cardiovascular issues due to Cannabis consumption. However, know your dosage and, if you’re taking any medication and you’re in a state where Cannabis is legal recreationally (or you’re an MMJ card carrier), please talk to your doctor.

  3. Anonymous

    There are some reports that heavy cannabis use by young people is bad for mental development. That seems to be the opposite for older people.

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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. dt2

    I think my diet has too much protein. making keto breath worse..

    I think I had Ketoacidosis at one point a while back.. and i'm doing better with that..
    I try to follow a lchf diet and yes, it keeps my bg low.. but I think I'm not doing it right..
    I am single and I don't cook much.. so I've been eating out .. denny's.. or a stake out.. or some wings from wingstop..
    I think everything is Eggs, Bacon, Sausage, Steak, Cheese, Chicken .. yea.. that's about it.. so yea all that is low carb, but there's not much green in there.. oh, green beens with my steak(s)..
    and I really felt like my keto breath wasn't getting better , it was getting worse.. so I read that to much protein can also cause bad breath.. maybe that's my problem.. I need more salads with some of the green stuff.. I found some stuff on this page.. http://thepaleodiet.com/bad-breath-b.../#.Vhrv-2sca0U .. yes, I know this is a little bit different diet, but I'm focusing on the added greens/vegetables it talks about
    it has caused me some distress.. I've had a couple times where I basically relapsed.. just being upset about my breath and the problems it has caused me.. not to mention, it's not easy to not have some of the things that I've eaten before.. the biscuits, pancakes, etc.. I'm trying.. but it's a struggle..
    When I felt like I was doing good on the diet, I think my breath was getting worse.. so I'm reevaluating some changes to make..

  2. furball64801

    I am doubting you were in DKA you might have been in ketosis which is another thing. They really are two different things. If you are not adding fat into the diet it should be that does help.

  3. dt2

    Originally Posted by furball64801
    I am doubting you were in DKA you might have been in ketosis which is another thing. They really are two different things. If you are not adding fat into the diet it should be that does help. ok.. I don't know if I was in DKA .. but this was a few months ago.. my a1c was over 15.. It was really before I started taking my diabetes seriously.. my nurse at the VA , she said that was the cause of my bad breath.. so I started working on it.. and after some more time ultimately ended up trying the lchf diet..
    I've done alot of reading.. got some keto stick to see when I go into ketosis.. etc.. I don't think I'm doing good for long periods of time.. I do good for a few days.. maybe 10 days at one point.. but I get upset because of the problems with my breath.. and if I relapse, I'm sure it kicks me out of ketosis ..

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