The Serum Anion Gap (AG)...Why is NAGMA associated with High Serum Chloride?

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3 жыл бұрын

Why is NAGMA associated with High Serum Chloride?
Why is normal anion gap metabolic acidosis (NAGMA) hyperchloremic? Have you ever wondered why?
#medicosis_ever_wonder-why?
There are 4 main conditions of Acid-Base Imbalance: Metabolic acidosis, Metabolic Alkalosis, Respiratory Acidosis, Respiratory Alkalosis..
Metabolic acidosis is subdivided into HAGMA and NAGMA.
We differentiate between HAGMA and NAGMA based on the serum anion gap (AG).
We differentiate between renal NAGMA vs non-renal NAGMA based on the urine anion gap (UAG).
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Пікірлер: 77

@MedicosisPerfectionalis 3 жыл бұрын

🧪 Acid-Base Lectures: www.medicosisperfectionalis.com/

@rumeysaeed1 3 жыл бұрын

I love the new series ever wonder why! As I ask “why” all the time. Gonna love that. And I am not a big fan of blindly memorising I am even scared of it. So I now know why ı like your channel &thank you!

@MedicosisPerfectionalis 3 жыл бұрын

Wow 🤩 You’re amazing!

@annawright4545 Жыл бұрын

The same is here. Finally all makes sense and work together.

@jangtank 2 жыл бұрын

Top notch stuff. Incredibly well explained. Liked + Subscribed + Notified. EDIT: Why is HAGMA normochloremic? HAGMA = Increased organic acids --> Dissociates into conjugate base & H+ --> Bicarb consumed to buffer H+ Net effect: Increased AG + Preservation of electroneutrality. Transcellular shifting of Cl not required

@MedicosisPerfectionalis 2 жыл бұрын

Thank you so much 😊

@talabatbouta 3 жыл бұрын

Hey medicosis i passed my hematology exam thanks to you and i just wanted to say thanks :)

@MedicosisPerfectionalis 3 жыл бұрын

Congratulations 🎉🎊🎈 That’s amazing!

@user-mi7pt4he2f 3 жыл бұрын

I m so happy to hear that you enjoy Sowell It is proof that you have a healthy non extremist mind I love this channel even more now We need more stuff like NAGMA 2021!

@MedicosisPerfectionalis 3 жыл бұрын

Thank you so much! I appreciate you!

@beenjammin8581 2 жыл бұрын

Maga. ;)

@xaaboopinkly 3 жыл бұрын

Thanks sir! Never going to miss any of your valuable videos and lectures!

@MedicosisPerfectionalis 3 жыл бұрын

My pleasure 😇 Thank you so much 😊

@afiohotu5059 2 ай бұрын

HAGMA is normochloremic because in this case no negative ion is being lost so no negative ion(i.e chloride) is gained. So chloride levels remain stagnant while bicarbonate levels drop Bicarbonate levels drop not because it is being lost but because it is being converted to carbonic acid by accepting a proton from the excess of organic acids in blood...... I think😅

@milymaj 2 жыл бұрын

Great, great, great video. Thank you. All makes sense now.

@MedicosisPerfectionalis Жыл бұрын

Thank you so much!

@egeuzunsakal7285 Жыл бұрын

Im amazed by how good you're teaching this stuff.

@MedicosisPerfectionalis Жыл бұрын

Thank you 😊

@clashju9965 2 жыл бұрын

Hey medicosis you explained so well Just wanna say thank you

@MedicosisPerfectionalis 2 жыл бұрын

My pleasure 😇

@74.santhoshkumar.m80 3 жыл бұрын

Super and marvelous and completely understandable video even if we start from 0

@MedicosisPerfectionalis 3 жыл бұрын

Thank you 🙏

@drew54948 Ай бұрын

Thomas sowell ❤️

@arunpragadesh2607 7 ай бұрын

Vera level💯💚

@nikolamarkovic4845 2 жыл бұрын

Tnx fpr reccomendetion of the books. Give us more that.

@MedicosisPerfectionalis 2 жыл бұрын

Thank you 🙏

@Lavanya-gf9bq Жыл бұрын

I understood that why NAGMA is hyperchloremic ....very well.... but am confused why your introduction says why NAGMA is normochloremic

@MedicosisPerfectionalis Жыл бұрын

I misspoke. NAGMA is hyperchloremic.

@user-eg3us6vo9f 10 ай бұрын

I cannot thank you enough ❤

@MedicosisPerfectionalis 10 ай бұрын

The pleasure is all mine! Would you please help me by sharing?

@meryamlazrak1329 11 ай бұрын

thank you sir❤❤

@gpgp4681 Жыл бұрын

Awesome lecture on the web

@MedicosisPerfectionalis Жыл бұрын

Thank you so much 😊

@ABC-fv7ow 2 жыл бұрын

You are awesome !

@MedicosisPerfectionalis 2 жыл бұрын

Thank you 😊

@salumsf192 3 жыл бұрын

Great video

@MedicosisPerfectionalis 3 жыл бұрын

Thank you so much 😊

@laerr2587 2 жыл бұрын

Our professors have to learn from u.

@MedicosisPerfectionalis 2 жыл бұрын

Thank you ☺️ for your kind words!

@thoriaessaghanm7185 3 жыл бұрын

Perfect

@MedicosisPerfectionalis 3 жыл бұрын

Thank you 🙏

@meryamlazrak1329 Жыл бұрын

thank you sir

@MedicosisPerfectionalis Жыл бұрын

My pleasure 😇

@omarkatranji3321 2 жыл бұрын

Legend Senna once said "If you no longer go for a gap that exists, you are no longer a racing driver", and since you say the gap does NOT exist... I'm sorry to say this but you ain't no racer anymore..

@beenjammin8581 2 жыл бұрын

I love Thomas sowell

@MedicosisPerfectionalis 2 жыл бұрын

I adore him :)

@thesmartpotato1854 6 ай бұрын

"there us no easter bunny, there's no tooth fairy, and there's no anion gap!" Great video, thanks a ton

@MedicosisPerfectionalis 6 ай бұрын

My pleasure!

@danachaar4917 3 жыл бұрын

Medicoosiis ❤️

@MedicosisPerfectionalis 3 жыл бұрын

Thank you 😊

@flightdoc9087 2 жыл бұрын

Good content.. but to me at least, the "Why?" intro was a bit too much.. like we got the point bro.. there's a lot of whys in medicine lol, 3 examples were already good enough.. no offense intended.

@MedicosisPerfectionalis 2 жыл бұрын

Thank you for your honesty!

@i__stand__with__palestine__ 3 жыл бұрын

🙌🙃

@MedicosisPerfectionalis 3 жыл бұрын

😊😊

@RR-js5yx 3 жыл бұрын

I'm sorry, but why is there no compensation of chloride electrolyte in HAGMA? Is it because there is no loss of bicarbonate?

@MedicosisPerfectionalis 3 жыл бұрын

Nope! Because in HAGMA, the original problem is not the loss of HCO3-, the original problem is a gain of an unmeasured anion (negative ion), therefore as a result of this gain of a negative ion, the body will lose another negative ion (HCO3-) to preserve electroneutrality. Chloride doesn’t enter into the equation. Does that make sense?

@RR-js5yx 3 жыл бұрын

@@MedicosisPerfectionalis yes, makes perfect sense. Thank you!!

@seva6611 2 жыл бұрын

@@MedicosisPerfectionalis omg 🤯🤯🤯

@gomekayira 6 ай бұрын

@@MedicosisPerfectionalisdufass you r a genius

@samstuart-gu9nh 7 ай бұрын

any guy cool with thomas sowell is cool with me

@MedicosisPerfectionalis 7 ай бұрын

🙏

@peterdreff3991 3 жыл бұрын

Dude, mmol/l … this should be used Get to your point quickly

@annawright4545 Жыл бұрын

Trying an answer to the Q: in NAGMA acidosis is due to loss of carbonate (by the doofuses) to which the Cl (-) gain is the correcting response, the quick-fix of the electroneutrality law. In HAGMA the acidosis is due to increased H (+) therefore the balancing response will be perhaps Na(+) gain in plasma (?). I might be wrong - just trying to take the challenge😊.

@MedicosisPerfectionalis Жыл бұрын

You’re correct in the first half!

@annawright4545 Жыл бұрын

@@MedicosisPerfectionalis Thank you for your feedback - I am going to find the second part, as the curiosity (the same that killed the cat...) is unbearable. Is there a title to the II. part?

@kachouriii Жыл бұрын

dear god how do you do this???????????????????????????????????????????????????????????? TOPPP NOOOTCH

@MedicosisPerfectionalis Жыл бұрын

Thank you so much 😊

@fra9985 Жыл бұрын

the first dang time i can tell it plainly in my head. not with all shitty terminology . n yest HAGMA mean external acid , so nothing is filling in its place, instead acid forms are adding up .

@someonenotyou 2 жыл бұрын

of all the things you say in your videos, you won't say "ass" 🤣

@MedicosisPerfectionalis 2 жыл бұрын

Haha 😂 Because I am a polite boy 😅

@MuhammadImran-sk7py Жыл бұрын

Your Vedios are amaizing ,but you are making vedios for earning dollors ,if u help humanity you should free all vedios like NINJA NERD,DR NAJJEEB

@dr_mridul_sharma 3 жыл бұрын

Arey NAGMA murder ho jayega 302 lagg jayega

@poeticindulgence753 3 жыл бұрын

Yes doofus 🤣🤣🤣

@MedicosisPerfectionalis Жыл бұрын

@modernmedicine2562 2 жыл бұрын

too much blabbering..here's a summary.. the AG is the space filled by anything else besides HCO3 and Cl. remember acidic compound will dissociate to from Hydrogen ions and Anions. The H+ from weak acids are buffered by the existing HCO3- while the A- anion constitute the Anion gap @ unmeasured anions. if you have a bigger gap, it basically means there's an "additional" anion which can be either endo/exogenous origin. --> hence why ingestion and organic acidoses are HAGMA. if the gap is normal, essentially nothing "additional" is gained, just simple loss (HCO3 loss and Cl reuptake) --> hence why the GAP is unaffected. AG doesnt tell you the severity of acidoses, but it give some clue to the potential causes.