Partially Compensated Metabolic Acidosis Example

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A discussion of the anion gap, including its calculation and its use in categorizing metabolic acidoses, including multiple examples of acid-base interpretation.

Abg Flashcards | Quizlet

5. And yes, ABG problems work using the Tic-Tac-Toe method. All you have to do is make a blank chart a bit like a tic-tac-toe chart. Using the lab result values, mark them on your Tic-Tac-Toe chart. Now begin with this given example. paCO2 is LOW = BASE so place paCO2 under Base HCO3 is LOW = ACID so place HCO3 under Acid In this step, look at which column matches up with the pH. In this case HCO3 goes with pH. HCO3 is considered Metabolic (shown in step 3), and both are under Acid, so this example implies Metabolic Acidosis. The last step is to determine if the ABG is Compensated, Partially Compensated, or Uncompensated. If pH is NORMAL, PaCO2 and HCO3 are both ABNORMAL = Compensated If pH is ABNORMAL, PaCO2 and HCO3 are both ABNORMAL = Partially Compensated If pH is ABNORMAL, PaCO2 or HCO3 is ABNORMAL = Uncompensated Therefore this ABG is METABOLIC ACIDOSIS, PARTIALLY COMPENSATED . pH is NORMAL = NORMAL so place pH under Normal PaCO2 is LOW = BASE so place PaCO2 under Base HCO3 is LOW = ACID so place HCO3 under Acid *Since the acidity of the blood is determined by the value of the pH, determine whether the normal pH is SLIGHTLY ACIDIC or SLIGHTLY BASIC. In this example, pH is NO Continue reading >>

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  1. MathWiz

    I wasn’t sure which section I should post this in, my strategy is what I call the 4–2–1 plan, I fast 2 day non consecutive days a week, eat a low carb but not calorie restricted diet 4 days a week to keep the fat burning benefits of ketosis going and then I give myself 1 day a week to indulge and eat whatever I want, usually a Saturday pasta dinner and wonderful dessert. I also walk 4 to 6 miles a day during the week and 10 to 12 miles on Saturday.
    Low Carb plans such as Atkins can be very effective for some people including me, many people who start a low carb diet experience get what’s called the “ketosis flu” or the “induction flu” in the first few days while the body is adapting to burning ketones instead of glucose.
    The basic symptoms are:
    – Headaches
    – Nausea
    – Upset stomach
    – Lack of mental clarity (brain fog)
    – Sleepiness
    – Fatigue
    It’s called the “ketosis flu” for a reason: you feel sick. I’ve gone through it and it wasn’t a pleasant experience. Fortunately it only lasted 2 days but then suddenly I woke up feeling much better, less hungry and my energy level was really high and consistent throughout the day!
    The first time I thought to myself: “What the heck am I doing? I feel like I’m going to die!” but I persevered and when it was over I didn’t regret a thing because what I had gained mentally and physically was 100% worth it.
    For those of you that are going through the ketosis flu, don’t give up! I know you feel like it’s never going to get better but stick with it and you´ll be so happy you did! I’m telling you, waking up refreshed for the first time in years, not getting the afternoon “blah” feeling and stuffing my face with carbs to try to boost my energy is the best side effect of the low carb diet I’ve experienced. Okay, losing weight while eating good food, feeling full and satisfied is great too.
    First you have to understand why your body is reacting this way. Your body’s been burning glucose for energy so it’s basically full of enzymes that are waiting to deal with the carbs you eat, but now the body needs to make new enzymes that burn fat for fuel instead of carbs, and the transition period causes the flu-like symptoms.
    There are some things you can do to lessen the symptoms of the ketosis flu and to make it go away sooner (to force the body to transition sooner) Ok, let’s get to the good part – what to do:
    First of all – you’re probably dehydrated. Drink PLENTY of water while you’re on a low carb diet, and then drink some more.
    Watch your electrolytes. When the body is getting rid of excess insulin from your former carb-crazy diet you´ll lose lots of fluids that have been retained in your body. This causes the rapid weight loss most people see in their first few days of ketosis, it’s mostly water, sorry. When you lose all the retained water you also lose electrolytes like sodium, magnesium and potassium. When you’re lacking them you´ll feel like crap so when you’re feeling really ill on the ketosis flu try things like chicken/beef broth and look for foods rich in these minerals. Take a multi-vitamin and a multi-mineral.
    Ok, here is where people throw the red flag – Eat more fat – Yup, I said MORE fat. Have some butter, just not on a roll, eat some bacon and eggs for breakfast, just skip the potatoes and toast. This will force your body to hurry up the transition. You´ll think this is crazy and think you´ll never get lose weight eating this way, but you will.
    Don’t eat too much protein – The body can transform protein into glucose so if you eat too much of it in the first days it will slow down the transition. Go for fatty meat and cheese if you can, add fat to protein shakes etc.
    Drink water, replenish electrolytes (sodium, magnesium, potassium) with food and supplements, drink broth, eat fat and not too much protein.
    I hope this helps, and have a great day

  2. rockyromero

    ” Take a multi-vitamin and a multi-mineral.”
    I have been forgetting to take a multi-vitamin on fast days. Thanks for the reminder.
    “Eat more fat – Yup, I said MORE fat. ”
    I will have avocado more often.

  3. AussieJess

    Thanks for that info, very interesting

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Acid-base Tutorial - Interpretation

by "Grog" (Alan W. Grogono), Professor Emeritus, Tulane University Department of Anesthesiology What is a moderate interpretation of the text? Halfway between what it really means and what you would like it to mean? - Antonin Scalia. This page describes the interpretation of the acid-base component of blood gas results. Designing the interactive acid-base diagram necessitated the development of a logical approach. This page converts the logic back into a human process. Constraints of Not Knowing Patient Details: In a Perfect World complete information about a patient is available before acid-base values are analyzed. What follows is a logical framework for looking at acid-base values with no patient. Reports may say that the results are "typical of" or "characteristic of" a single clinical problem. However, identical results can also be obtained from a complex combination of clinical problems. Step 1: Is the pH normal, acid, or alkaline critical because it governs all the subsequent thinking. In acute problems the change is usually acidic - a low pH - e.g., 7.2 or 7.1. This is because failure, either respiratory or metabolic, results in the accumulation of acids. The following par Continue reading >>

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  1. marcustomp

    The ketogenic diet (often referred to as “keto”). Today I speak about my keto experience and the basics of a ketogenic diet.
    What is the ketogenic diet?
    I’m no stranger to self-experimenting, playing around with my diet and trying to optimise my nutrition. I’ve been practising intermittent fasting for nearly 4 years now, but there’s a specific diet i’ve been meaning to try - the ketogenic diet.
    Firstly for those who don’t know the ketogenic diet is a low-carb, high fat diet (LCHF) with many health benefits.
    It involves drastically reducing carbohydrate intake, and replacing it with fat. The reduction in carbs puts your body into a metabolic state called ketosis.
    When this happens, your body becomes incredibly efficient at burning fat for energy. It also turns fat into ketones in the liver, which can supply energy for the brain.
    Ketogenic diets can cause massive reductions in blood sugar and insulin levels. This, along with the increased ketones, has numerous health benefits, such as: the potential to fight against diabetes, epilepsy, Alzheimer’s disease and even cancer.
    There are also four different classifications of the ketogenic diet. The standard ketogenic diet is accepted as reducing your carbohydrates intake to 5% carbs, with just enough protein (20%, let’s say) and the rest coming from fats.
    The basic principle around ketogenic diets is that our bodies first port of call for energy are carbohydrates or glucose. Think about a fridge, the fridge is analogous to carbohydrates because they’re easy to access. Then we have the freezer, equivalent to fat, it’s more difficult to access, as we have to bend down or walk to the basement. The flip side is that there’s more energy in there. #Classifications
    Other classifications of ketogenic diets are higher protein, or more advanced models like targeted kept which is manipulating carbohydrate consumption around workouts so that one has greater athletic performance and potentially a greater ability to gain muscle (as this is one aspect of your body composition which is harder to progress in).
    There is also cycling ketogenic, or carb-cycling which is just alternative days of ketogenic dieting, but for now we’re sticking to the standard model.
    Dietary restrictions:
    The basis of ketogenic diets are avoiding carbohydrates and yes this includes fruit.
    Foods you should avoid:
    Avoid carb-based foods like grains, sugars, legumes, rice, potatoes, candy, juice, alcohol, unhealthy fat and even most fruits
    Foods you should eat:
    Base the majority of your diet on foods such as meat, fish, eggs, butter, nuts, cheese, full-cream (no-milk) healthy oils, avocados and plenty of low-carb veggies.
    Side effects:
    Keto-flu. As your body is adapting you may find yourself with flu like symptoms (ket-flu)
    Fatigue, lethargy, urine smell, breathe smell, constipation
    Many doctors recommended added salt when starting out as your body adjusts.
    Magnesium is also important.
    Increase your fibre intake, eat a lot of spinach and other green vegetables as well as plenty of water (not too much)
    You can also purchase exogenous ketones which kick-start the state of ketosis in the body, but I think this is unnecessary for someone just beginning.
    Remember that a caloric deficit is always required for weight loss to actually occur.
    In terms of alcohol, small amounts of red wine can be acceptable on the diet, or hard liquors (which of course I don’t recommend).
    Eating out. Simply order a normal meal but replace the carbohydrates with extra vegetables.
    Foods I’ve been eating.
    90% chocolate Almonds A lot of salmon. Occasional grass-fed steak Olive oil Olives Grass-fed butter, Spinach Mixed green vegetables
    My personal experience (WEEK 1)
    I think my experience has been very smooth; for one I made sure to slowly reduce the amount of carbohydrates in my diet in the previous week in order to not “shock” the body.
    I’ve also been practising intermittent fasting for years, which is essentially a close cousin of ketogenic diets and mimic some of the effects.
    For the first two days I felt a little fatigued, but after the third day I found my cognitive processing to increase greatly.
    Another point is that I think i’m going to have to reduce my fasting windows to something less extreme so I can actually consume to appropriate amount of calories.
    I’m not trying to lose weight, I’m using the ketogenic diet simply to self-experiment and see if my body, but more specifically, mind prefers it for being more productive and focused.
    Concluding points:
    But it’s a great diet for losing weight, firstly of course because of the reduced insulin levels, but also for other reasons such as increased protein intake and increased fibre which are going to help you reduce your appetite.
    If you are losing weight combining this with intermittent fasting is an incredibly powerful formula one could say to drop weight quickly.
    Overall it’s been interesting so far. I’m really excited to see how this plays out as it’s something I’ve wanted to do for a long time.
    All the best.

  2. mallardcove

    So you have done it for one week and felt the need to write a post about it? I'd have stuck at it a little longer.
    Personally I think keto is fine if your goal is strictly to lose weight, but if you are trying to add muscle/strength it's not optimal.

  3. leonardo_vetra

    Agreed - a week is barely enough to get past the carb withdrawals and start feeling the benefits of becoming fat adapted. The weight dropped is likely just water weight from ceasing to eat so much processed food.

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This video describes a little about our method of teaching the physical exam at the bedside. Our goal is not only to teach the exam, but also to teach others to teach the technique of physical diagnosis! Here is a link to the document describing our teaching methods (shown in the video): http://stanford25blog.stanford.edu/20... More about us: The Stanford Medicine 25 program for bedside medicine at the Stanford School of Medicine aims to promote the culture of bedside medicine to make current and future physicians and other healthcare provides better at the art of physical diagnosis. Visit us: Website: http://stanfordmedicine25.stanford.edu/ Blog: http://stanford25blog.stanford.edu/ Facebook: http://www.facebook.com/StanfordMedic... Twitter: https://twitter.com/StanfordMed25

Blood Gas Analysis For Bedside Diagnosis

Department of Oral and Maxillofacial Surgery, Post Graduate Institute of Dental Sciences, Rohtak, Haryana, India Address for correspondence: Dr. Virendra Singh, Department of Oral and Maxillofacial Surgery, Post Graduate Institute of Dental Sciences, Pt. B.D. Sharma University of Health Sciences, Rohtak, Haryana - 124 001, India. E-mail: [email protected] Author information Copyright and License information Disclaimer Copyright : National Journal of Maxillofacial Surgery This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. This article has been cited by other articles in PMC. Arterial blood gas is an important routine investigation to monitor the acid-base balance of patients, effectiveness of gas exchange, and the state of their voluntary respiratory control. Majority of the oral and maxillofacial surgeons find it difficult to interpret and clinically correlate the arterial blood gas report in their everyday practice. This has led to underutilization of this simple t Continue reading >>

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  1. thedoctor_89

    Hey everyone. I have a question for you. After losing 70 lb in half a year i decided to stop keto. I like it but i want to move on to something else. Is there anyway that i could stop keto with gaining weight from carbs. Im prepared to spend a month to do this if i have to.

  2. jrf_1973

    Eh, not really. When you go low carb and lose the water weight in the first week, that is weight you will put back on once you reintroduce carbs.
    Basically your body will build back its reserves of glycogen, and that glycogen will store water. There's no way to avoid that.

  3. thefoxman88

    Can always go a few lb below your goal so when you go back to normal you are at your goal weight.

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