2min chapter

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225. Down to the Basics - An Approach to Acid Base Disorders

The Intern At Work: Internal Medicine

CHAPTER

Identifying Mixed Acid-Base Disorders

Understanding the complexities of diagnosing mixed acid-based disorders through analysis of normal pH, abnormal bicarbonate, and CO2 values. Exploring the critical relationship between PCO2 and bicarbonate levels to uncover concurrent processes affecting pH balance.

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However, this process
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can be more challenging when there is more than one type of acid-based disturbance occurring at the same time. This is called a mixed disorder. There are two clues that can suggest a mixed disorder. First, if the pH is normal or extreme in either direction, for instance, less than 7.2 or greater than 7.6, if the pH is normal and the bicarbonate and CO2 values are not, it suggests that the pH is balanced because there are two underlying processes, an acidosis and an alkalosis, that change the pH equally in opposite directions. The second clue is if the PCO2 and bicarbonate move in opposite directions. Normally, they move in the same direction as one compensates for the other. For example, if the bicarbonate is low, you would expect the PCO2 to be lower because you have less buffer available to compensate for the acid. However, if they move in opposite directions, it may be because there are two processes occurring at the same time. Congratulations! You've made it to the end of the podcast. Thank you for listening to this episode of the Internet Work, entitled Down to the Basics and Approach to Acid-Based Disorders. This episode was written by Dr. Caroline Nadger, Internal Medicine resident, and reviewed by Dr. Bernard Unikovsky, Nephrologist, and Dr. Jesse Popov, General Internist. This episode was recorded and produced by Alison Lai. The Internet Work series was created by Alison Lai, and is executively produced by Alison Lai, Leah Kerenoplas, and Zara Morale. As always, be of an Associated Infographic Honor website at www.theinternetwork.com. Thank you for listening, and we hope to see you again soon.

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