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The Intern At Work: Internal Medicine
225. Down to the Basics - An Approach to Acid Base Disorders
Feb 25, 2024
Dr. Caroline Najjar, Dr. Bernard Unikowsky, and Dr. Jesse Popov discuss acid-base disorders in a 5-step approach. They explore the physiological basis, compensation mechanisms, anion gap calculation, and identifying mixed acid-base disorders. Highlights include respiratory and renal system roles, metabolic alkalosis, anion gap metabolic acidosis, and diagnosing concurrent processes affecting pH balance.
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Quick takeaways
- Understanding acid-base disorders involves recognizing pH levels to differentiate acidosis or alkalosis.
- Interpreting anion gap and delta ratio aids in diagnosing metabolic acidosis and identifying underlying causes.
Deep dives
Understanding Acid-Base Homeostasis
The body regulates its acid-base balance within a pH range of 7.35 to 7.45 to prevent denaturation of proteins, which can lead to symptoms like nausea, tremors, and coma. The pH reflects the solution's acidity or basicity, determined by the hydrogen ion concentration calculated using the negative log. Bicarbonate and PCO2 levels play a crucial role in maintaining this balance, with kidneys managing bicarbonate and respiration controlling PCO2 by eliminating volatile acids.
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