GOLD MARK. This mnemonic provides some general situations that would produce an anion gap acidosis. A normal anion gap is typically < 12. The general way to think about this is to subtract the total amount of negative anions from the total amount of positive cations.The positive cations used are sodium and potassium. If a gap is present of >14 mEq/L (Normal value: 10-14 mEq/L), a high anion gap is identified, and metabolic acidosis is present in the body. Thank you for using EZmed!- Free animations and videos that correspond with each blog- Free mnemonics, tricks, and strategies to learn and remember the content- Help to improve your exam scores and classroom performanceWe respect your privacy. Anion gap = [Na + K] - [HCO3 + Cl] Pay attention to the normal anion gap values at your hospital/institution or lab as they can vary slightly. Enjoy the video above that provides a concise explanation filled with animations and illustrations to everything presented below.Arterial blood gases (ABGs) are useful in determining a patient’s acid base status, and can also provide some insight regarding the severity of the patient’s illness or the underlying pathophysiology taking place. This platform and its contributors are not responsible from damages arising from its use. Normal Anion Gap Metabolic Acidosis (NAGMA). See this thread for a similar issue Abdulaziz (02-21-2012), … He coordinates the Alfred ICU’s education and simulation programmes and runs the unit’s education website, His one great achievement is being the father of two amazing children. It may even help you consider what to order such as: glucose (DKA), ethanol level, lactate, chemistry (uremia), volatile alcohol panel (methanol), co-oximetry (carbon monoxide), etc.Hopefully this post provided you with an easy explanation on how to calculate an anion gap.Use the CAT MUDPILES mnemonic to help you remember the main causes of high anion gap metabolic acidosis.If you enjoyed the content in this post, don’t forget to join the EZmed community for free on the bottom of the page or in the navigation bar so you don’t miss out on future medical topics made easy. L-lactate, Now that we know how to calculate an anion gap in the presence of metabolic acidosis, it is important to know what disease states can cause this presentation. Renal tubular acidosis is a common cause of normal anion gap metabolic acidosis but these disorders can be easily missed or misdiagnosed. The anion total is then subtracted from the cation total. HCO3 loss and replaced with Cl- -> anion gap normal. 2 26070 14. As I’ve mentioned previously on this blog, the “MUDPALES” mnemonic for anion gap metabolic acidosis is one of the most successful medical mnemonic’s of all time. September 1, 2008. An anion gap acidosis occurs when the substances responsible for causing metabolic acidosis are unmeasurable or not indicated by anions or cations (i.e. He has completed fellowship training in both intensive care medicine and emergency medicine, as well as post-graduate training in biochemistry, clinical toxicology, clinical epidemiology, and health professional education.He is actively involved in in using translational simulation to improve patient care and the design of processes and systems at Alfred Health. Chris is an Intensivist and ECMO specialist at the After finishing his medical degree at the University of Auckland, he continued post-graduate training in New Zealand as well as Australia’s Northern Territory, Perth and Melbourne. unmeasured plasma anions include plasma proteins, citrate, phosphate, and sulfate anion gap = Na+ - (Cl- + HCO3-) normal = 8-16 mEq/L anion gap is very useful for narrowing the differential diagnosis of metabolic acidosis If it is metabolic or respiratory, this is an essential pre-determining factor when figuring out the type of acid-base imbalance and the proper intervention. See Terms of Service and Privacy Policy above for more detail. The content is not guaranteed to be error free. Mnemonic for NON-Anion Gap Metabolic Acidosis. The EZmed platform is meant to provide information for free medical education and should not serve as clinical advice for patients or providers. The negative anions used are bicarbonate and chloride. 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