Acid/Base

Question 1

What does a negative urine anion gap usually indicate?

Answer 1

neGUTive (loss of bicarb from the gut)

Positive is usually RTA (impaired renal acidification)

Question 2

What is the equation for osmolar gap?

Answer 2

Measured posm - calculated posm, where:

plasma osmolarity = 2(Na) +glucose/18 +BUN/2.8

Question 3

What are the causes of an increased osmolar gap?

Answer 3

ethanol, ethylene glycol, methanol, acetone, isopropyl ethanol and propylene glycol.

Question 4

What is the delta ration?

Answer 4

d(anion gap) / d(HCO3)

Question 5

What does a value of less than 1 for a delta ratio indicate? More than 2?

Answer 5

Less than 1 = There is a simultaneous normal anion gap acidosis

More than 2 = simultaneous metabolic alkalosis present or a compensated chronic respiratory acidosis.