ABG Part 3 [metabolic acidosis]
Medgeeks with Andrew Reid
Medgeeks
4.8 • 997 Ratings
🗓️ 17 August 2018
⏱️ 10 minutes
🧾️ Download transcript
Summary
This acid base disorder requires multiple steps!
So, make sure to pay close attention to this one.
But, what are common metabolic acidosis disorders? Well, everyone jumps to MUDPILES.
The first step, however, is to determine if there's an increased anion gap or not. Remember, the body already has a normal anion gap (difference between anions and cations).
Clinical pearl for all you Medgeeks: the anion gap is affected by albumin and this is the most abundant unmeasured anion in the body.Therefore, if albumin is low, then the normal anion gap in the body is lowered.
For everyone 1 unit decrease in the albumin from 4, then the normal anion gap drops by 2.5.
If there's an increased anion gap - then we think MUDPILES
So let's jump right in to metabolic acidosis!
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Transcript
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| 0:00.0 | Team Zack here from med geeks we're back over halfway there part three of the |
| 0:06.9 | acid-based disorder lectures today's an important one we're going to tackle |
| 0:12.1 | metabolic acidosis. This acid-based |
| 0:15.7 | disorder requires multiple steps so be a sponge, soak it up. So quickly, once again |
| 0:21.2 | what are the normal pH 7.35 to 7.45. |
| 0:26.5 | If the pH is less than 7.35, acidemia. |
| 0:30.4 | If the pH is greater than 7.45, alkylemia. |
| 0:35.0 | Normal bicarb is 22 to 26, normal PC02, 35 to 45, |
| 0:41.0 | generally speaking, pH and biccar move in the same direction from normal. It's a primary |
| 0:46.8 | metabolic process. pH and PCO2 move in opposite directions from normal. it's a primary respiratory process. |
| 0:55.1 | So what are common primary metabolic acidosis disorders? |
| 0:58.9 | Well, everyone jumps to mud piles. |
| 1:02.0 | It's like Pem-Doss of grad school, but first you need to determine |
| 1:06.6 | whether there's an anion gap or not. Remember, the body already has a normal anion gap, the difference between the unmeasured anions and catines. |
| 1:17.0 | But sometimes this anion gap can increase. |
| 1:20.0 | I normally use greater than 12, but each is different so a quick clinical purl. |
| 1:26.1 | The anion gap is affected by alveumin and this is the most abundant unmeasured anion in the body. Therefore, if alveumum is low, the normal, quote-unquote, |
| 1:37.0 | anion and gap in the body is lowered. So for every one unit decrease in the |
| 1:41.4 | alveumin from four, the normal, quote unquote, anion |
| 1:44.8 | gap drops by 2.5. So let's say there is an increase in your quote unquote normal anion |
| 1:51.6 | gap that the body has, |
| 1:53.3 | then you're gonna think about piles. |
... |
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