Anion gap = Difference between the unmeasured cations and unmeasured anions in the serum [artificial]
It will done with serum (has clotting factor removed) or with plasma [MOST OFTEN DONE WITH SERUM]
= ([Na+]) − ([Cl−] + [HCO3−]) = 10 , if greater than 12, IAGMA (when K+ is added, it is ~16)
*You can remove potassium due to its low concentration often having little or no effect on the gap
NORMALLY, there are cations > anions, so the gap is + [BUT plasma is overall electrically neutral]
Increase in this gap will result in increased ion gap acidosis [AKA a drop in the Cl- or Bicarbonate] which will result in more unmeasured anions needed to counter balance the sodium/ unmeasured cations.
WHAT DROPS THE HC03 or Cl-???
There will be an increase in unmeasured acids, that will dissociate into their weak conjugate base (unmeasured anion) AND Hydrogen; the hydrogen will bind with HC03 and shift the equilibrium LEFT [reducing bicarbonate].
WHAT CAUSES THE INCREASED ION GAP ACIDOSIS?
*There is also MUDPILES
1. Chapter 17. Pancreatic Hormones and Diabetes Mellitus. Greenspan’s Basic & Clinical Endocrinology, 9e
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