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Acid Base Disorders - Formulas for appropriate metabolic and respiratory compensation

- Dr Amith Sreedharan - Consultant
Acid Base Disorders ... #Acidosis #Alkalosis ... #Compensation # ... Formula #Winters #Diagnosis ... #Nephrology #AcidBase
Summary of metabolic compensation for respiratory acid-base disorders
#Diagnosis #Nephro #Respiratory #Acidosis #Alkalosis #Metabolic #Compensation #Formulas #Curbsiders
compensation for ... respiratory acid-base ... disorders #Diagnosis ... #Respiratory #Acidosis ... Formulas #Curbsiders
Acid Base Compensation - Directions - If all three variables (pH, HCO2, pCO2) move in the
Acid Base Compensation ... #Diagnosis #Nephro ... #AcidBase #Acidosis ... #Alkalosis #Metabolic ... #Curbsiders
Acid-Base Disorders - Differential Diagnosis Framework

 • Respiratory Acidosis
 • Respiratory Alkalosis
 • Metabolic Acidosis
 •
Acid-Base Disorders ... AcidosisMetabolic ... Kfischer_10 #AcidBase ... #Acid #Base #Disorders ... #diagnosis #acidosis
Acid-Base Disorders - Differential Diagnosis Algorithm
Acidemia (pH < 7.35)
 • Metabolic Acidosis (HCO3 < 24mmol/L) CO2
Acid-Base Disorders ... - Differential Diagnosis ... Acidosis (HCO3 ... < 35 mmHg) #AcidBase ... #Causes #Compensation
Approach to Acid Base Disorders - Evaluation and Differential Diagnosis
1) Start with the Anion Gap (AG).
2)
Disorders - Evaluation ... and Differential Diagnosis ... 3) Now, look at ... the appropriate compensation ... Differential Diagnosis
Acid Base Disorders - Blood Gas Interpretation

Steps for Blood Gas Interpretation: 
1. Acidemia or Alkalemia? 
2.
Acid Base Disorders ... MDaniyalHashmi1 #AcidBase ... #Diagnosis #Summary ... #Nephrology #ABG ... bloodgas #Acid #Base
Hypokalemia - Differential Diagnosis Algorithm
Extra-renal Losses:
 • Normal Acid-Base: Low intake
 • Metabolic acidosis: Gl tract
- Differential Diagnosis ... • Normal Acid-Base ... Metabolic acidosis ... Algorithm #causes #potassium ... #low #nephrology
Metabolic Alkalosis - Urinary Chloride Algorithm
Cl- responsive metabolic alkalosis
 • Kidney loss of Cl-
alkalosis • Normal/low ... poisoning Normal acid-base ... of sodium and potassium ... urine #Algorithm #nephrology ... #differential #diagnosis
Gitelman Syndrome Overview

What?
• Inherited (AR) hypokalemic salt-losing tubulopathies affecting the thiazide-sensitive sodium chloride cotransporter
• Gitelman's syndrome
alkalosis • Normal or low ... Hypochloremic metabolic ... Renal tubular acidosis ... Gitelman #Syndrome #diagnosis ... #nephrology #management