All right, so welcome back to the Internet Book of Critic Care podcast.

I'm here with Adam Thomas.

And we're going to come at you this week with three little small chapters.

It's metabolic paloza.

So we started off with a basic approach to diagnosis.

And in this cast, we're going to cover Anandgap metabolic

acetosis. Before we get into it, though, Josh, let's set the groundwork. What do we want to emphasize?

I think the main emphasis here is really just diagnosis, differential diagnosis in the approach.

The exact therapy depends largely on the specific ideology, so we're not going to go too far down

that rabbit hole. So take a look at the post. We've covered this in the basic approach, but really we're going down step one.

You're going to calculate the an an an an an an end gap.

And that shoots us down.

Wow.

The anon gap is elevated.

So then we're going to look at the bicarb. And as Josh has walked you through multiple times now,

you're going to see is the bicarb low? Is it within a normal range or is it elevated? Now the causes.

Josh, mud piles. I can't even remember one from mud piles. So I think the easier approach people

would say is cout. So ketones, uremic acid, lactic acidosis, and toxins.

Do you agree with this?

Do you not agree with it?

How does your mind work?

Yeah, I think that's pretty good.

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