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A Stepwise Approach for Acid‐base and Acute Metabolic Disorders
A Stepwise Approach for any Acidbase problems in the step 2 ck exam
1 ‐ What is the likely clinical diagnosis (based on history) *ASA overdose – mixed *Vomiting – alkalosis *COPD with sepsis – mixed resp and met acidosis *COPD with sepsis and vomiting – triple acid base – resp acidosis, gap acidosis and metabolic alkalosis *COPD with sepsis and diarrhea – triple acid base – respiratory acidosis, gap and non‐gap metabolic acidosis 2 ‐ Alkalosis or acidosis *< 7.40 primary disorder = acidosis *> 7.40 primary disorder = alkalosis 3 ‐ Calculate the anion Gap *Anion gap = Na – HCO3 – Cl *Normal gap is 12 +/‐ 2 (10 to 14) 4 ‐ Calculate the Delta gap (To verify if a there is a “hidden” coexistent) *Delta gap = anion gap – 12 (the calculated anion gap – normal anion gap) *Compared to normal range ‐ > Normal (24) → metabolic alkalosis ‐ < Normal (24) → hyperchloremic acidosis 5 Calculate and starting HCO3 * starting HCO3= Delta gap + current HCO3 – If starting HCO3 < 24 = a coexistent non‐gap metabolic acidosis is present – If starting HCO3 > 24 = a coexistent metabolic alkalosis is present 6‐ check for respiratory compensation 7 ‐ Is it simple or mixed acid‐base disorder 8 ‐ Make clinical correlation and final diagnosis Plz refer to ALL Possible Acidbase problems 
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#2




more reading required prior doing this
wer can i read more. this was too precise. im really bad with this calculations.do u have any links wer i can learn it in broader way

#3




Quote:
WF= HCO3*1.5+8 it should give u compensated value of CO2 if its more than expected then its combined acidosis this is helpful in any case of M. acidosis 
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#4




For sure if you read this thread carefully and then practice Qs from bottom link you will be satisfied, if not you can use internet.

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