#AcidBase Twitter Polls

Here a collection of our #AcidBase Twitter Polls (and the answers!):

Poll #20:

Answer: IV diazepam

p: Acidemia
L: Low PCO2, low HCO3 –> Primary metabolic acidosis
A: 141 – 108 – 12 = 21 (normal = 10, albumin 4 g/dL)
C: Expected PCO2 = 1.5 (12) + 8 = 26 (28 – 30)  –> Adequate respiratory compensation
O:  Calculated osm = 2*Na + glucose/18 + BUN/2.8 = 2 (141) + 99/18 + 12/2.8 = 292
Serum osm – calculated osm = 333 – 292 = OSMOLAL GAP!

Propylene glycol (present in formulations of intravenous diazepam) cause an elevated anion gap metabolic acidosis AND and increased osmolal gap. Isopropyl alcohol does NOT increase the anion gap, but does increase the osmolal gap.


Poll #19:


Poll #18:

Answer:
p: Alkalemia
L: Low PCO2, low HCO3 –> Primary respiratory alkalosis –> Decompensated cirrhosis 


Poll #17:

Answer:
p: Acidemia
L: Low PCO2, low HCO3 –> Primary metabolic acidosis
A: 135 – 106 – 16 = 13 (normal = 10, albumin 4 g/dL)
C: Expected PCO2 = 1.5 (16) + 8 = 32 (28 – 30)  –> Adequate respiratory compensation
O: No osmolality provided, Delta/Delta = 3/8 –> suggests presence of non-anion gap metabolic acidosis

Urine anion gap: Na (50) + K (60) – Cl (30)  = (+) –> suggests kidney bicarbonate wasting –> RTA

Of the answers provided, hyperkalemia suggests a type 4 RTA


Poll #16:


Poll #15:


Poll #14:


Poll #13:


Poll #12:


Poll #11:


Poll #10:


Poll #9:


Poll #8:


Poll #7:


Poll #6:


Poll #5:


Poll #4:


Poll #3:


Poll #2:


Poll #1: