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Old 06-09-2011
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Question Anion gap and non anion gap acidosis

I have a lot of confusion regarding which types of acidosis are anion gap and which are non anion gap and why ???what us the normal anion gap and how do we approach questions if anion gap acidosis!!!
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Old 06-09-2011
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I always say that people should take Step 1 first before attempting the CK, and this is one of the examples, you are facing anion gap issues because you did not read for Step 1.
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Old 06-09-2011
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ma is divided into anion gap (with incr anion gao) & non anion gap(normal anion gap)...normal anion gap is 8-12.....
anion gap-->endogenous or exogenous acid with corresponding anion increase and cl remain constant...MUDPILES
NON ANION GAP--> NO endogenous or exogenous acid is added,its only due to hco3 loss....rta,diarrhea,fistula
calculated by: Na-(hco3+cl)
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Old 06-09-2011
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as far as i know in step1 we should know that following are types of acidosis with normal anion gap

1) DIARRHEA
2) RTA 1
3) RTA 2

I watched Robert Dunn lectures he said for step 1 they will not go beyond this....
but if u are asking for step 2 and details I am sorry...
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Old 06-10-2011
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Default Calculation tool!

Normal range: 8 to 16 meq/L

Anion gap = [Na+] - [Cl-] - [HCO3-]
or alternative formula:
AG = [Na+] + [K+] - [Cl-] - [HCO3-].

The anion gap can be used to help identify the cause of metabolic acidosis.

http://www.globalrph.com/anion_gap.htm
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Old 06-10-2011
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Default Useful mnemonic for noral anion gap!

Normal anion gap

In patients with a normal anion gap the drop in HCO3− is compensated for almost completely by an increase in Cl− and hence is also known as hyperchloremic acidosis.
The HCO3− lost is replaced by a chloride anion, and thus there is a normal anion gap.
Note: a useful mnemonic to remember this is FUSEDCARS (fistula (pancreatic), uretogastric conduits, saline administration, endocrine (hyperparathyroidism), diarrhea, carbonic anhydrase inhibitors (acetazolamide), ammonium chloride, renal tubular acidosis, spironolactone)
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Old 06-10-2011
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I'm visual and I best understand different problems with pics. Here my picture from my notes.http://deyneko.com/forum/index.php/board,7.0.html

So see at this picture, there are two columns: at the left cations, at the right anions. They are in equilibrium, it is mean that scale (in real - volume) left and right columns (anions vs cations) must be equal. Anion gap (small red box) in other words it is anions which we can not measure (phosphate, citrate, sulfate, and protein).

Just two simple examples, other you can see from other posts (and compare with the pic).
In metabolic acidosis HCO3 decreases (for buffering fixed acid) -> another anion must replace HCO3 - it could be Cl- in this situation the anion gap is normal. In case that another anion will replace HCO3 -> anion gap changes, as you understand - increases. Anion gap is normal in hyperchloremic metabolic acidosis because Cl- increases and replaces HCO3.

Hope it helps for other visuals
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Default Anion gap!

Very helpful indeed dyneko!
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Really helpful thanks :-)
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