This is amazing. Thank you so much. You made 3 and a half weeks of incomprehensible lectures seem like something that I'm ready to tutor in a matter of an hour. That is incredible.
Dr. Seheult, Thank you sooo..... much for making these videos. No body ever explained acid-base this clearly. The book that we follow did not help to understand. Your lecture helped me to understand acid-base. We are using the acid-base graph to plot the values but did not have a clear understanding of what it meant. After you explained the graph, I can understand better about what it is. You started from the basics and explained step-by-step. Now, I am able to work out the example problems that you have used in this video. Thank you.
OMG!!! I LOVE YOU!!!!!!! FINALLY I KNOW WHY THE WINTER'S FORMULA IS THAT IMPORTANT, NOW I GOTTA GO BACK AND TAKE NOTES ALL THOSE FORMULAS THAT I SKIPPED xD
You guys should team up with KhanAcademy... love his site but it sorely lacks in the more technical/professional medical subjects. It would give you more exposure and probably more resources. Either way, keep doing what you're doing.
I understand why the second example at around 10:50 is chronic respiratory alkalosis, but couldn't there also potentially be a non-AG metabolic acidosis occurring concurrently, as the pH is within the normal range and when you add the delta AG to the bicarbonate level, it is less than the normal bicarbonate level which would indicate normal AG metabolic acidosis?
That is exactly what I'd like to know... I paused the video to solve the problem myself, came to a conclusion of having NAG-MAc + Respiratory Alkalosis, so the actual result in the video surprised me.
Thank You very much for your Videos! they're really helping me a lot, especially as they're covering the topic into the depth and don't consider things compensated according to a normal pH or not (which a lot of videos do!) Still I have a question with the second case you present (chronic respiratory Alkalosis). If I continue the ∆GAP calculations, like You showed us in the previous videos, I'll add ∆GAP to the Bicarb (19 + (-1) = 18) which is far of from 22-24 and thus we should have a metabolic non-anion-gap-increasing Acidosis as well? Or is that calculation only to be conducted if there's an ∆GAP > 1? I know You're probably busy with the situation around COVID-19 thus I'd appreciate an answer whenever there's time again! Thank You a lot for ALL the videos!
Thank you sir, but am bit confuse , the time you introduced cam 7 you used cl as 104, in expl 1 you used 106, and now in expl 2 you used 110, i just become confuse, please help
Overall great videos, which have raised my knowledge by far. But, I have a question regarding the pCO2 reference which you display as 4.0 or 40. pH (7,35-7,45), pCO2 (4,5-6,0), HCO3- (22-26). Why is the pCO2 reference value not "52"?
Thanks for the great videos! Could you please tell why the Cl values are different in eache case, bearing in mind you put normal values for the other parametes in the C7. thanks in advance
i do not think i will need to memorize the winters formula & i do not think i will need it .. i can differentiate between acute & chronic respiratory alkalosis or acidosis by seeing if there is compensation happened or not i.e in the hco3 .
+mohama ansary Here's a cool trick: At the end of working out the ABG, instead of using Winter's Formulas just do this: Add "16" to the Bicarb concentration. If the result is less than "40" then there is a respiratory alkalosis, if it is higher than it is a respiratory acidosis. (quick and dirty) - but it works most of the time!
What do you do if for example you have a patient with a primary resp acidosis but instead of bicarb going up it actually went down? pts anion gap was normal, AG was 8 with albumin of 3. Would you say that this is a resp acidosis with concurrent non gap acidosis? abg is 7.05/61/116/17
WHO said the global health emergency announcement is primarily to help poor countries contain the virus and not a measure of severity. I guess they learned a lesson from the 2009 Pandemic where the impact was mostly felt in vulnerable developing nations
On the first question, you used 26 as the normal HCO3- while applying Winters' Formula, but used 24 in the second problem.....does it matter which you use? Should we just use 25, since there's no even number in the middle of the normal HCO3- range?
I found in Tortora that normal Na is 142, normal Cl is 100, and normal HCO3 is 24. Together these give an anion gap of 18 rather than 12. Can you solve this for me? Thanks. I enjoyed the lecture. Very helpful. But I kept thinking of the other gap.
Dale Tidd hi, not sure if you'll still read this but reference values of electrolytes vary in different sources. Medcram used a value of 104 for chloride in part 2 of this series. 140-(104+24)=12 😁
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This is amazing. Thank you so much. You made 3 and a half weeks of incomprehensible lectures seem like something that I'm ready to tutor in a matter of an hour. That is incredible.
Shane Naidoo Good to hear- thanks for the great feedback
Thank you so much. You're helping us to become great doctors. I really appreciate that❤️
I hit the liked button before I watch it. I always struggle with acid base, and you made it so easy to understand! Thank you so much!!!!
Thank you very much sir, you cleared my concepts regarding ABGs
Dr. Seheult, Thank you sooo..... much for making these videos. No body ever explained acid-base this clearly. The book that we follow did not help to understand. Your lecture helped me to understand acid-base. We are using the acid-base graph to plot the values but did not have a clear understanding of what it meant. After you explained the graph, I can understand better about what it is. You started from the basics and explained step-by-step. Now, I am able to work out the example problems that you have used in this video. Thank you.
Yanky Doodle Thanks for the feedback- glad you found the series helpful
Thanks a lot. May God almighty bless you with all peace and prosperity.
Very good step wise explanation ...
OMG!!! I LOVE YOU!!!!!!! FINALLY I KNOW WHY THE WINTER'S FORMULA IS THAT IMPORTANT, NOW I GOTTA GO BACK AND TAKE NOTES ALL THOSE FORMULAS THAT I SKIPPED xD
Very useful series of lectures.
You guys should team up with KhanAcademy... love his site but it sorely lacks in the more technical/professional medical subjects. It would give you more exposure and probably more resources. Either way, keep doing what you're doing.
Thank you for this brilliant series
I understand why the second example at around 10:50 is chronic respiratory alkalosis, but couldn't there also potentially be a non-AG metabolic acidosis occurring concurrently, as the pH is within the normal range and when you add the delta AG to the bicarbonate level, it is less than the normal bicarbonate level which would indicate normal AG metabolic acidosis?
That is exactly what I'd like to know... I paused the video to solve the problem myself, came to a conclusion of having NAG-MAc + Respiratory Alkalosis, so the actual result in the video surprised me.
Thank you so much... really great illustration thanks again
these videos are really helpful thank you so so much. please consider making more teaching videos.
Winthers formula ratios for chronic respiratory acidosis is stated both 1/2 (at first) but then in the following example as 1/3.
Sure, we just got started so more's on the way.
Your videos are amazing. Please upload more.
+bug bumble Thanks for the comment
Thank you for the amazing videos. they are so helpful. I have one problem understanding, how did you get the value for Chloride ion ? Thank you again
thank you!! this was really, REALLY helpful!
You're most welcome, thanks for the comment!
Na range is 135-145, Cl also has a range too. so numbers move around.
Na = 140. Cl = 104 HCO3 = 24 are averages.
Thank you very much.Easy to understand.
Clear and informative...thank you
Very helpful practice problems..thanks
awesome!!!!Talented Teacher. Thank you so much. You teach very clearly.
dehunter456 Glad the video was helpful- thank you.
Thank You very much for your Videos! they're really helping me a lot, especially as they're covering the topic into the depth and don't consider things compensated according to a normal pH or not (which a lot of videos do!)
Still I have a question with the second case you present (chronic respiratory Alkalosis).
If I continue the ∆GAP calculations, like You showed us in the previous videos, I'll add ∆GAP to the Bicarb (19 + (-1) = 18) which is far of from 22-24 and thus we should have a metabolic non-anion-gap-increasing Acidosis as well? Or is that calculation only to be conducted if there's an ∆GAP > 1?
I know You're probably busy with the situation around COVID-19 thus I'd appreciate an answer whenever there's time again!
Thank You a lot for ALL the videos!
Thank you sir, but am bit confuse , the time you introduced cam 7 you used cl as 104, in expl 1 you used 106, and now in expl 2 you used 110, i just become confuse, please help
the ones he is giving you here are just examples to work with and figure out the patient's AG. They are not the normal values for Chloride.
Overall great videos, which have raised my knowledge by far. But, I have a question regarding the pCO2 reference which you display as 4.0 or 40. pH (7,35-7,45), pCO2 (4,5-6,0), HCO3- (22-26). Why is the pCO2 reference value not "52"?
Thanks for the great videos! Could you please tell why the Cl values are different in eache case, bearing in mind you put normal values for the other parametes in the C7. thanks in advance
i do not think i will need to memorize the winters formula & i do not think i will need it .. i can differentiate between acute & chronic respiratory alkalosis or acidosis by seeing if there is compensation happened or not i.e in the hco3 .
and it works perfect
+mohama ansary Here's a cool trick: At the end of working out the ABG, instead of using Winter's Formulas just do this: Add "16" to the Bicarb concentration. If the result is less than "40" then there is a respiratory alkalosis, if it is higher than it is a respiratory acidosis. (quick and dirty) - but it works most of the time!
+MEDCRAMvideos thanQ .. It helped indeed :)
What do you do if for example you have a patient with a primary resp acidosis but instead of bicarb going up it actually went down? pts anion gap was normal, AG was 8 with albumin of 3. Would you say that this is a resp acidosis with concurrent non gap acidosis? abg is 7.05/61/116/17
Thanku..very helpful
Thank you very much
thankkkk you so muchhh 💜💕💕
WHO said the global health emergency announcement is primarily to help poor countries contain the virus and not a measure of severity. I guess they learned a lesson from the 2009 Pandemic where the impact was mostly felt in vulnerable developing nations
On the first question, you used 26 as the normal HCO3- while applying Winters' Formula, but used 24 in the second problem.....does it matter which you use? Should we just use 25, since there's no even number in the middle of the normal HCO3- range?
Doesnt matter, as long as it is close to the value
So where does base excess come into the equation? Is it just the same as calculating the delta gap?
base excess is another way of saying metabolic alkalosis.
I found in Tortora that normal Na is 142, normal Cl is 100, and normal HCO3 is 24. Together these give an anion gap of 18 rather than 12. Can you solve this for me? Thanks. I enjoyed the lecture. Very helpful. But I kept thinking of the other gap.
Dale Tidd hi, not sure if you'll still read this but reference values of electrolytes vary in different sources. Medcram used a value of 104 for chloride in part 2 of this series. 140-(104+24)=12 😁
sorry, just realised you randomly make them up..
I completely disagree with you. Acute and chronic respiratory alkalosis is explained in vice versa fashion. It is the opposite of what you said.
+kushal tejawat perhaps you could be more specific.
My bad..... I didn't check the calculation part properly.