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The anion gap [1] [2] (AG or AGAP) is a value calculated from the results of multiple individual medical lab tests.It may be reported with the results of an electrolyte panel, which is often performed as part of a comprehensive metabolic panel.
High anion gap metabolic acidosis is a form of metabolic acidosis characterized by a high anion gap (a medical value based on the concentrations of ions in a patient's serum). Metabolic acidosis occurs when the body produces too much acid , or when the kidneys are not removing enough acid from the body.
In general, the cause of a hyperchloremic metabolic acidosis is a loss of base, either a gastrointestinal loss or a renal loss [citation needed]. Gastrointestinal loss of bicarbonate (HCO − 3) [citation needed] Severe diarrhea (vomiting will tend to cause hypochloraemic alkalosis) Pancreatic fistula with loss of bicarbonate rich pancreatic fluid
For a list of the common anions responsible, see high anion gap metabolic acidosis. KULT is probably the easiest of the mnemonics to use (Ketones, Uremia, Lactate, Toxins). Toxins are an uncommon cause of high anion gap metabolic acidosis – a list of the commonest toxins is ACE GIFTs [ibid]. Metformin as a pure toxicological cause is ...
The serum anion gap is useful for determining whether a base deficit is caused by addition of acid or loss of bicarbonate. Base deficit with elevated anion gap indicates addition of acid (e.g., ketoacidosis). Base deficit with normal anion gap indicates loss of bicarbonate (e.g., diarrhea).
Hyperparathyroidism – can cause hyperchloremia and increase renal bicarbonate loss, which may result in a normal anion gap metabolic acidosis. Patients with hyperparathyroidism may have a lower than normal pH, slightly decreased PaCO2 due to respiratory compensation, a decreased bicarbonate level, and a normal anion gap. [3]
Region D: the new meter's values are so inaccurate that it would fail to detect potentially dangerous hypoglycemia or hyperglycemia; and Region E: the new meter not only fails to detect potentially dangerous hypoglycemia or hyperglycemia (as in Region D), but it also mistakes one condition for the other (for example, reporting a hyperglycemic ...
It covers ICD codes 240 to 279. The full chapter can be found on pages 145 to 165 of Volume 1, which contains all (sub)categories of the ICD-9. Volume 2 is an alphabetical index of Volume 1. Both volumes can be downloaded for free from the website of the World Health Organization.