acid base status

Question 1

how do you calculate anion gap?

Answer 1

(Na +K)-(Cl+HCO3)
normally around 1-=16 mmol/l adn reflects the concentration of those anions actually present but not routinally measured such as plasma proteins, phosphates and organic acids

Question 2

what is the anion gap?

Answer 2

routine serum elecctrolyte determination measures most of the cations but only a few of the anions. This apparent disparity between the total cation and the total anion concentration is called the anion gap

Question 3

most common 4 causes of increased anion gap metabolic acidosis

Answer 3

Ketones
Ureamia
Lactate
Toxins

Question 4

the toxicological causes of increased anion gap metabolic acidosis

Answer 4

Iron, isoniazid
Metformin
Phenformin, paraldehyde
Aspirin, acetaminophen, alcohols
Cyanide, carbon monoxide (CN, CO)
Toluene

Question 5

with metabolic acidosis get low pH and low Bicarbonate . what are the causes of a normal anion gap metabolic acidosis?

Answer 5

1. intestinal loss of base eg diarrhoea, fistulae, ureterosigmoidostomy, (transplantation of ureters).
2. renal loss of base eg renal tubular acidosis (type 1 and 2), pyelonephritis.
3. therapy with carbonic anhydrase inhibitors eg acetozolamide, ammonium chloride and rarely with hyperalimentation.
   Conditions that cause a metabolic acidosis without increase in unmeasured anions are associated with high serum chloride.