A 45-year-old man with a history of poorly controlled type 2 diabetes mellitus is brought to the emergency department due to confusion, nausea, and abdominal pain for the past 2 days. He has missed his last several doses of insulin. His temperature is 37.1°C (98.8°F), blood pressure is 100/65 mm Hg, pulse is 112/min, and respirations are 24/min. Physical examination shows dry mucous membranes and a fruity breath odor.
Laboratory studies show:
| Laboratory Test | Result |
|---|---|
| Sodium | 142 mEq/L |
| Potassium | 4.8 mEq/L |
| Chloride | 102 mEq/L |
| Bicarbonate | 14 mEq/L |
| Blood urea nitrogen | 25 mg/dL |
| Creatinine | 1.4 mg/dL |
| Glucose | 450 mg/dL |
What is this patient's serum anion gap (in mEq/L)?
Cevap: 26 mEq/L
Cevap
26
The serum anion gap is calculated using the formula: . Using the patient's laboratory values, the calculation is mEq/L. A normal anion gap is typically between 8 and 12 mEq/L. This patient has an elevated anion gap of 26 mEq/L, consistent with high anion gap metabolic acidosis secondary to diabetic ketoacidosis.
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Anahtar Kavram
Calculation of the serum anion gap in the evaluation of metabolic acidosis