Spent an hour trying to understand this and couldn't, then i came to RU-vid and a 7-minute video explains it superbly! Thank you very much! Keep up the amazing videos!
My God I am in my final year of MBBS and am now trying to clear all my bad conceptss and trust me I never got the hang of inc. or dec. Anion gap until now!! Thank you. Thank you sm!!!!!
Never have I ever seen a better explanation. You helped me A LOT. Thank you so much. It makes me happy to see there are good people in the world that want to help others, like you did by sharing your knowledge. Greetings from Brazil (today I felt like all of my effort to learn English was worth it because if I hadn’t studied it I wouldn’t be able to watch your video and I’d still be struggling with this anion gap thing lol)
When binding sites are same for both calcium and protons during metabolic acidosis hypercalcemia occurs then why they say metabolic acidosis leads to decrease in myocardial contractility 🤷🏾♂️🤷🏾♂️🤷🏾♂️ Please explain!!
Killer video man! One small thing I noticed though. Looks like you forgot the parentheses on the equation both times you show it, 0:39 and 1:23. The equation is Anion Gap = ([Na+] + [K+]) − ([Cl−] + [HCO3−]). If you don't have the parentheses, the equation is Anion Gap = [Na+] + [K+] − [Cl−] + [HCO3−] and that would mean the subtraction wouldn't distribute to the bicarbonate as well, instead only applying to the Chloride. This would mean you'd be adding the bicarbonate. You got the math correct in your example though so I know you understand what you're talking about! Just thought I'd point that out so that it doesn't confuse anyone. Confused me for a bit haha. Thanks for the post!
Yes, I agree with the previous correction. RTA type II is caused by impairment of the PROXIMAL tubule which cannot absorb bicarb and that gives you the acidotic state. The type I is the impairment of the distal tubule which cannot excrete H protons (acid) and that gives you the acidosis. Anyway, your video was EXTREMELY helpful and I've watched it a thousand times because I always forget this topic and your video is always the easy super nice way to remember. Thank you SO MUCH!
Thanks for filling in a 20+ year knowledge gap. I just converted everything you said into written notes - like almost every word - and now I feel like the fog has lifted. Finally. You are a star!💥
Learned about this in med but they never really explained what it was all about. They told me to know the equation and memorize MUDPILES and etc. This brings it all together, thank you so much!
Just to echo previous happy commenters, thank you for this excellent little video - clearly and succinctly explained with some humour thrown in as well! Much appreciated
I am so thankful to u doc ; u saved me from my consultant when he made round and asked me a flowwww of questions hoping he could get me . But with this video I opposed him professionally 😎😎😎😎 Lol thanks really
Oh my gosh, thank you! I have been asking people to explain this to me for years and no one has ever been able to or taken the time to. I am a nurse and doctors (especially new doctors, for some reason) get so worked up about the anion gap and I am always asking them about why this is so important and they just can never tell me. So frustrating since I need to understand these decisions that drive patient care. This was such a clear and straight forward explanation. Thank you! really cool information too, the human body is amazing.
I remember Anion Gap very well ... Gary Puckett ... "Woman" ... "Young Girl" ... "This Girl Is A Woman Now" ... and all those other borderline pedophilic releases. Disturbing, but nice to dance to.
Fantastic video, as it finally helped me understand this topic! But I think you got the Renal Tubular Acidosis portion confused, since the Type 1 Distal form is due to defective hydrogen secretion, whereas Type 2 Proximal form is the decreased bicarbonate reabsorption.
Mind the gap! Raised Anion gap causes: MUDPILES Methanol, Uremia, Diabetic ketoacidosis (or alcoholic ketoacidosis,) Paraldehyde, Iron (or Isoniazid,) Lactic acidosis, Ethylene glycol, and Salicylates.
Half of the practicing life is gone..........and then we realize that, these so called complex concepts were so simple and basic. Thanks..for making things simple..
Had my theory exams a week ago and was quite shaky about the concept and now I have viva in a few days and thankfully I found this gem although I’m mad at myself for not finding this a bit earlier
u latterly saved my life and my time , at first when i opened the video and heard the silly music in the back i had doubts lol , but this vedio helped beyond what i expected , THANK U
Excellent video keeping it simple as I was getting confused by the whole "renal vs GI" thing that's come up in lectures! Edit: your video provides a good base to build upon. Basically, in NAGMA, GI loss of HCO3 (diarrhea) causes kidneys to increase NH4+ excretion, resulting in decreased AG but if there is a renal loss of HCO3, then kidneys cannot respond by increasing NH4+ excretion, and you end up with HAGMA. For now, I'm happy with this as a base for my knowledge! Cheers!
I’m confused by one thing though.. if the high anion gap acidosis has an electro neutral serum as opposed to an acidic one… how do you know the person is in acidosis? And why would it even be classified as acidosis if the person has a normal serum pH?
was helpful but please correct the equation, if you're subtracting the bicarb it should be either minus bicarb or chloride and bicarb both are bw the same one big bracket, this is just for the people copying from the video
So let me get straight, if u had a high anion gap then u could just eat bicarbonate and that would decrease the gap then?? I'm a welder not a doctor so don't kill me:)
