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

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  • เผยแพร่เมื่อ 20 ม.ค. 2025

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  • @MedicosisPerfectionalis
    @MedicosisPerfectionalis  3 ปีที่แล้ว +1

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

  • @rumeysaeed1
    @rumeysaeed1 3 ปีที่แล้ว +21

    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!

  • @jangtank
    @jangtank 2 ปีที่แล้ว +10

    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

  • @afiohotu5059
    @afiohotu5059 9 หลายเดือนก่อน +6

    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😅

  • @talabatbouta
    @talabatbouta 3 ปีที่แล้ว +3

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

  • @ΜουΒου
    @ΜουΒου 3 ปีที่แล้ว +1

    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!

  • @74.santhoshkumar.m80
    @74.santhoshkumar.m80 3 ปีที่แล้ว +2

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

  • @xaaboopinkly
    @xaaboopinkly 3 ปีที่แล้ว +1

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

  • @egeuzunsakal7285
    @egeuzunsakal7285 2 ปีที่แล้ว +2

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

  • @drew54948
    @drew54948 7 หลายเดือนก่อน +1

    Thomas sowell ❤️

  • @milymaj
    @milymaj 2 ปีที่แล้ว

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

  • @Lavanya-gf9bq
    @Lavanya-gf9bq ปีที่แล้ว +3

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

  • @clashju9965
    @clashju9965 3 ปีที่แล้ว +1

    Hey medicosis you explained so well
    Just wanna say thank you

  • @arunpragadesh2607
    @arunpragadesh2607 ปีที่แล้ว

    Vera level💯💚

  • @Miri-e6m
    @Miri-e6m ปีที่แล้ว +1

    I cannot thank you enough ❤

  • @nikolamarkovic4845
    @nikolamarkovic4845 3 ปีที่แล้ว +1

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

  • @gpgp4681
    @gpgp4681 2 ปีที่แล้ว

    Awesome lecture on the web

  • @Ahdbfbfbeh
    @Ahdbfbfbeh 3 ปีที่แล้ว +1

    I love Thomas sowell

  • @salumsf192
    @salumsf192 3 ปีที่แล้ว +1

    Great video

  • @ABC-fv7ow
    @ABC-fv7ow 3 ปีที่แล้ว +1

    You are awesome !

  • @meryamlazrak1329
    @meryamlazrak1329 ปีที่แล้ว

    thank you sir❤❤

  • @thoriaessaghanm7185
    @thoriaessaghanm7185 3 ปีที่แล้ว +2

    Perfect

  • @flightdoc9087
    @flightdoc9087 2 ปีที่แล้ว +2

    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.

  • @laerr2587
    @laerr2587 3 ปีที่แล้ว

    Our professors have to learn from u.

  • @arisandra
    @arisandra 2 หลายเดือนก่อน +1

    goated video

  • @thesmartpotato1854
    @thesmartpotato1854 ปีที่แล้ว +1

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

  • @omarkatranji3321
    @omarkatranji3321 2 ปีที่แล้ว +2

    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..

  • @danachaar4917
    @danachaar4917 3 ปีที่แล้ว +1

    Medicoosiis ❤️

  • @RR-js5yx
    @RR-js5yx 3 ปีที่แล้ว

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

    • @MedicosisPerfectionalis
      @MedicosisPerfectionalis  3 ปีที่แล้ว +5

      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
      @RR-js5yx 3 ปีที่แล้ว

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

    • @seva6611
      @seva6611 3 ปีที่แล้ว

      @@MedicosisPerfectionalis omg 🤯🤯🤯

    • @gomekayira
      @gomekayira ปีที่แล้ว

      ​@@MedicosisPerfectionalisdufass you r a genius

    • @livingstonsharon1956
      @livingstonsharon1956 3 หลายเดือนก่อน

      But isn't acidosis a result of H+ ions? Isn't that positive ion? And isn't there is a loss of HCO3 due to a reaction with the H+?-​@@MedicosisPerfectionalis

  • @meryamlazrak1329
    @meryamlazrak1329 2 ปีที่แล้ว

    thank you sir

  • @samstuart-gu9nh
    @samstuart-gu9nh ปีที่แล้ว +1

    any guy cool with thomas sowell is cool with me

  • @peterdreff3991
    @peterdreff3991 3 ปีที่แล้ว +1

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

  • @i__stand__with__palestine__
    @i__stand__with__palestine__ 3 ปีที่แล้ว

    🙌🙃

  • @kachouriii
    @kachouriii ปีที่แล้ว +1

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

  • @modernmedicine2562
    @modernmedicine2562 3 ปีที่แล้ว +3

    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.

  • @fra9985
    @fra9985 ปีที่แล้ว

    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
    @someonenotyou 3 ปีที่แล้ว

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

  • @MuhammadImran-sk7py
    @MuhammadImran-sk7py ปีที่แล้ว

    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

  • @annawright4545
    @annawright4545 2 ปีที่แล้ว +1

    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
      @MedicosisPerfectionalis  2 ปีที่แล้ว +2

      You’re correct in the first half!

    • @annawright4545
      @annawright4545 2 ปีที่แล้ว

      @@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?

  • @dr_mridul_sharma
    @dr_mridul_sharma 3 ปีที่แล้ว

    Arey NAGMA murder ho jayega
    302 lagg jayega

  • @poeticindulgence753
    @poeticindulgence753 3 ปีที่แล้ว +1

    Yes doofus 🤣🤣🤣