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What Is Non Anion Gap Metabolic Acidosis?

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

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. zetaphine

    I'm in my 6th day of Induction and my Ketostix are not registering any changes. I drink about 112 ounces of water daily. Could I be drinking too much water and diluting the results? Thanks in advance for any light you can shed on the topic.

  2. JustJ280

    Hmmm.... well, I can say that there are people who will get into Ketosis and the strips never show anything. Not sure why -- I've never used them because I can tell when I'm there -- I feel different. But just in case, why not post an example menu so that we can see if there is anything that stands out? Sorry I couldn't be more help right off the bat!

  3. zetaphine

    Quote:

    Originally Posted by JustJ280
    why not post an example menu so that we can see if there is anything that stands out? JustJ280: Thanks for the quick reply! Here's today's plan:
    Breakfast:1 Atkins Bar
    2 cups coffee with heavy cream
    Snack:Red pepper slices
    Lunch:Chicken salad (canned chicken, mayo, celery, chives)
    Salad mix
    1 TBSP bacon
    2 TBSP ranch dressing
    1/4 cup mushrooms
    Dinner @ Ruby Tuesday:Sole & shrimp
    Roasted spaghetti squash
    Grilled asparagus
    I calculate 29 grams of carbs. Lemme know what you think.

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High anion gap metabolic acidosis

Renal Fellow Network: Mnemonic For Non-anion Gap Metabolic Acidosis

Mnemonic for NON-Anion Gap Metabolic Acidosis As I've mentioned previously on this blog, the "MUDPALES" mnemonic for anion gap metabolic acidosis is one of the most successful medical mnemonic's of all time. A less successful (and admittedly less useful) mnemonic exists for non-anion gap metabolic acidoses (NAGMA), which I learned as a resident. It's "HARDUP", which stands for the following: H = hyperalimentation (e.g., starting TPN). R = renal tubular acidosis (Type I = distal; Type II = proximal; Type IV = hyporeninemic hypoaldosteronism. U = uretosigmoid fistula (because the colon will waste bicarbonate). P = pancreatic fistula (because of alkali loss--the pancreas secretes a bicarbonate-rich fluid). Practically speaking however, the two main causes you really have to remember for NAGMA are DIARRHEA or RENAL TUBULAR ACIDOSIS, which 90% of the time you can distinguish between based on the history alone. Another way to think about the differential diagnosis of NAGMA is to ask whether or not there is GI LOSS or RENAL LOSS of bicarbonate. If the history does not provide an obvious explanation, one can distinguish between GI versus renal bicarbonate losses by determining the urine a Continue reading >>

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  1. beezala

    Hey everyone,
    I just wanted to tell people the cause of my hair loss issue, and to tell you to GO TO YOUR DOCTOR IF YOU ARE LOSING HAIR ON KETO. After 3 months I started losing hair and got a few greys, which I've never had before.
    Under everyone's advice here and on the web, I assumed it was telogen effluvium, which is common and temporary.
    After getting blood work, my doctor said I am very low in b12, which cab cause hair loss and loss of hair pigment. The solution for me: supplement daily with 1000mg b12. This is my first day supplementing.
    If left untreated, low b12 can be catastrophic. So please, do get checked out. B12 comes from animal products, so you must be wondering HOW I could possibly low on that if I eat keto.
    Apparently, it has something to do with grass fed animal products; the meat and cheese from these animals has higher levels of b12 than that of the grain fed variety. Also, it can be found in fruits and grains, which have been completely removed from my diet.
    Just some food for thought.
    EDIT: I've just read about how antibiotics can lead to b12 deficiency. I have posted before about antibiotics ruining my gut microbiome, and now I think it may have been the cause of my b12 deficiency. Apparently bad gut bacteria eats up the b12, so an overgrowth of it may be the culprit. But won't jump to conclusions until I speak with my doctor. The antibiotic I took was doxycycline for keto rash...
    UPDATE: Today is the first day I am noticing a little less hair loss than normal and it has been exactly 3 weeks since I started supplementing. There is less hair on my clothing/around me, but I am still not back to normal. Another symptom I've had is very dry/scaly/itchy scalp, which has appeared to calm down a bit the last couple of days. I'm hoping this means my body is readjusting to normal levels! Feeling optimistic.
    UPDATE 2: Confirming that after almost exactly 1 month of b12 supplementation, my hair loss is back to normal! Also, want to clarify that all of this is most likely NOT related to the Keto WOE, as my iron levels are also low and this is genetic, and apparently, they are related. Still waiting to hear from my doctor, but I may have a minor form of Thalassemia.

  2. hazeFL

    There is no B12 in fruit or grains.

  3. Addbutter

    I thought it was common knowledge since vegetarians always have to worry about not getting b12.

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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

Review Of The Diagnostic Evaluation Of Normal Anion Gap Metabolic Acidosis

Acid-Base, Electrolyte and Fluid Alterations: Review Review of the Diagnostic Evaluation of Normal Anion Gap Metabolic Acidosis I have read the Karger Terms and Conditions and agree. I have read the Karger Terms and Conditions and agree. Buy a Karger Article Bundle (KAB) and profit from a discount! If you would like to redeem your KAB credit, please log in . Save over 20% compared to the individual article price. Buy Cloud Access for unlimited viewing via different devices Access to all articles of the subscribed year(s) guaranteed for 5 years Unlimited re-access via Subscriber Login or MyKarger Unrestricted printing, no saving restrictions for personal use * The final prices may differ from the prices shown due to specifics of VAT rules. For additional information: Background: Normal anion gap metabolic acidosis is a common but often misdiagnosed clinical condition associated with diarrhea and renal tubular acidosis (RTA). Early identification of RTA remains challenging for inexperienced physicians, and diagnosis and treatment are often delayed. Summary: The presence of RTA should be considered in any patient with a high chloride level when the CL-/Na+ ratio is above 0.79, if the Continue reading >>

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  1. ww_je

    Yes you can certainly die. And you can suffer more or less permanent organ dmaage from it as well;.
    It develops, most commonly in Type 1 diabetics, when insulin dosage is wrong, as the result of infection, stress, ... It is the result of the production of ketone bodies (three intermediate chemicals in the fat oxidation sequence), only one of which is actually a ketone (it's acetone). when enough of these reach the bloodstream, the entire chenmical condition of the body goes acidic. Since most of the biochemical reactions we need don't work or don't work when the acidity goes too high. It's so important that there is an entire buffering system to keep the pH of the blood and tissues correct.
    Diabetic ketoacidosis is an absolute medical emergency and a case srious enough to have 'acetone breath' (a sign of advanced DKA) cannot be treated at home with rest and fluids and so on. DKA is not something to treat casually.
    The treatment is to slowly restore normal pH, get the production of ketone bodies to sotop, and watch carefully for Potassium levels and such. The 'ambos' can't really do this in teh few minutes they will have with you. They can administer fluids adn check vitals, but more is neede than they can do in a brief ambulance run. If you go unconscious, the ER doc on the other end o fthe radio might order a PH raising IV drip, but withou careful blood chemistry monitoring, even this is probably postponable until reaching the ER.

  2. Lurline

    This Site Might Help You.
    RE:
    can you die from dibetic keto acidosis? and what can the ambos do to save you?

  3. creola

    Diabetes is usually treated through a combination of diet (low sugar), exercise and medications/insulin. Read here https://tr.im/S4PB1
    Milder cases can be controlled with just diet an/or exercise while more severe cases require meds or insulin as well.

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