low anion gap
TRANSCRIPT
negative anion gap
other anions
Cl
HCO3
other cations
Na
Anions Cations=
Gamblegram
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
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
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
Sodium 128 Potassium 4.7 Chloride 97 Carbon dioxide 32 Glucose 103 Osmolality 303
anion gap -1