Anion Gap and Osmolar Gap (High): Difference between revisions

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==DDx==
==Calculations==
===TOXICOLOGICAL===
===Anion Gap===
#methanol
AG = Na - (Cl  +  HCO3)
#ethanol glycol
===Calculated Osm===
#salicylates
Calculated Osm = 2 x Na + (glu/18) + (BUN/2.8) + (ethanol/4.6) + (methanol/2.6) + (ethylene glycol/5) + (acetone/5.5) + (isopropanol/5.9)
#iron
*Normal = 275-295
#inh
===Osmolal Gap===
#paraldehyde
Osmolal Gap = measured osm - calculated osm
#alcoholic ketoacidosis
*Normal = (-)14-10 mOsm/L
#inhalants- CN, CO, H2S
#toluene


===NONTOX===
==Differential Diagnosis==
#lactic acidosis
===Toxicological===
#dm ketoacidosis
*[[Methanol Poisoning|Methanol]]
#uremia
*[[Ethylene Glycol Poisoning|Ethanol glycol]]
*[[Aspirin (Salicylate) Toxicity]]
*[[Iron Toxicity|Iron]]
*[[INH]]
*Paraldehyde
*[[Alcoholic Ketoacidosis]]
*Inhalants - [[CN]], [[CO]], [[Hydrogen Sulfide]]
*Toluene


===MUDPILES===
===Non-Toxicological===
M- methanol
*[[Lactic Acidosis]]
*[[DKA]]
*[[Uremia]]


U- uremia
{{CAT MUDPILERS}}


D- dka
==Evaluation==
{{Toxic Alcohols Anion/Osmolar Gaps}}


P- paraldehyde
==See Also==
*[[Osmolal or Osmolar Gap]]
*[[Anion Gap (High)]]
*[[Toxidromes]]


I- iron. inh
==External Links==
*[http://www.mdcalc.com/serum-osmolality-osmolarity/ MDCalc - Serum Osmolality/Osmolarity]
*[http://www.mdcalc.com/anion-gap/ MDCalc - Anion Gap]


L- lactic acidosis
==References==
 
<references/>
E- ethylene glycol
 
S- salicylates
 
==Source==
MISTRY 6/06


[[Category:FEN]]
[[Category:FEN]]
[[Category:Tox]]
[[Category:Toxicology]]

Latest revision as of 11:56, 23 July 2016

Calculations

Anion Gap

AG = Na - (Cl + HCO3)

Calculated Osm

Calculated Osm = 2 x Na + (glu/18) + (BUN/2.8) + (ethanol/4.6) + (methanol/2.6) + (ethylene glycol/5) + (acetone/5.5) + (isopropanol/5.9)

  • Normal = 275-295

Osmolal Gap

Osmolal Gap = measured osm - calculated osm

  • Normal = (-)14-10 mOsm/L

Differential Diagnosis

Toxicological

Non-Toxicological

CAT MUDPILERS

Evaluation

Toxic Alcohols Anion/Osmolar Gaps

Osmolar gap Metabolic acidosis Osmolar gap Anion gap Ketones Ca Oxolate stones Reduced vision Management
Ethanol + + + (if ketoacidosis) + - Mainly supportive
Ethylene glycol + + + - + - Fomepizole, Thiamine, Pyridoxine, +/- Dialysis
Methanol + + (early on, then disappears) + - - + Fomepizole or ethanol, Folinic acid, +/- Dialysis
Isopropyl alcohol - + - + - + Mainly supportive
Propylene gylcol + + (initially) + (converted to lactate) - - -

See Also

External Links

References

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