Download - Low anion gap
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negative anion gap
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other anions
Cl
HCO3
other cations
Na
Anions Cations=
Gamblegram
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THE ANION GAP
other anions
Cl
HCO3
other cations
Na
Anions Cations=
Cl + HCO3 + other anions Na + other cations=
Cl + HCO3 + other anions – other cations Na=
other anions – other cations Na – (Cl + HCO3)=THE ANION GAP
the anion gap
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THE ANION GAPother anions
Cl
HCO3
other cations
Na
Anions Cations=
other anions – other cations Na – (Cl + HCO3)=
Occurs with metabolic acidosis
Addition of exogenous or endogenous acids
G glycols O oxoproline L l-lactic acid D d-lactic acid M methanol A aspirin R renal failure K ketones
Increased “other anions” Could theoretically occur with decreased “other cations”
THE ANION GAP
increased anion gap
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THE ANION GAPother anions
Cl
HCO3
other cations
Na
Anions Cations=
other anions – other cations Na – (Cl + HCO3)=
Occurs due to decreased anions
Albumin Proteins Phosphorus Sulfates IgA
THE ANION GAP
Due to increased cations
Potassium Calcium Magnesium Lithium IgG Bromide
decreased anion gap
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Sodium 128 Potassium 4.7 Chloride 97 Carbon dioxide 32 Glucose 103 Osmolality 303
anion gap -1