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Acid/Base Phys - Coggle Diagram

- - - - Unmeasured means not measured for the AG equation
  - - - lactate
      - ketones
      - uremic acids
    - - ethylene glycol,
      - salicylic acid
  - - - it can affect the AG
      - decreases can lower the AG
      - increases can increase the AG
  - - - makes your AG negative!!!!
      - The analyzer reads bromide as Cl!
  - - - Lactic acidosis in exercising horses
      - Grain overload causing lactic acidosis
    - - Diabetic ketoacidosis or other ketone producing conditions
      - Uremic acidosis
      - Intoxication-ethylene glycol
    - - Know the calculation AG=(Na+K)-(Cl + HCO3)
      - Know it generally increases with certain acid buildups in metabolic acidosis
      - Lactate, ketones, uremic acids, ethylene glycol
        
        Unmeasured anions are the primary driver to increase AG
        
        Conceptually AG = UA-UC=(Na+K)-(Cl + HCO3)
- - - - Can calculate corrected Cl to look at Na affects and free water loss
        
        will not need to calculate this FYI
      - Cl corr=(mean Na of RI* / measured Na) X measured Cl
      - If after correction Cl is still below the Cl RI then you have a disproportionate hypochloremia or above the RI a disproportionate hyperchloremia
  - - - In this scenario AG is generally normal and you are losing bicarbonate either in the kidney or diarrhea or saliva in some species
      - Because bicarbonate is negatively charged, the body wants to maintain electroneutrality and retains Cl (along with H+ in the kidney) and this retention leads to an additive excess
      - Voila you have an acidosis!
      - Causes include
        
        secretory diarrhea compensation
        
        proximal or distal rental tubular acidosis
        
        choke (loss of bicarb in saliva)
    - - Loss of H+ and Cl in vomit or sequestration (GDV, abomasal disorders, ileus/reflux, some diuretics)
      - Normally HCL is excreted in the stomach in exchange for generation of bicarbonate in the blood (normally this bicarbonate is taken up by the pancreas and excreted into the intestine with pancreatic secretion to neutralize HCL from the stomach)
      - If there is lack of HCL delivery to the intestine then HCO3 builds up leading to alkalosis
      - At the same time Cl is negatively charged and so body generates and retains bicarbonate to offset the lack of negative charged Cl that is being lost
- - - - Consumption of bicarbonate to buffer
        
        non-volatile acids
        
        non-chloride acids
    - - Loss or lack of production of bicarbonate or gain of chloride containing acid
- - - - HCO3HCO3 (bicarbonate)= major extracellular buffer
        
        TCO2 is essentially the same as HCO3)
- - - - Titrational acidosis/high anion gap metabolic acidosis
      - Normal anion gap/hyperchloremic metabolic acidosis