PDF slides are available for each. Emma Hollidays pediatrics lecture is a two-hour run-through of all the major high-yield concepts likely to be tested on shelf exams (Step2CK) or med school rotations/placement tests. Definition. Am J Kidney Dis 2011; 58:480. Emmas delivery is easy to understand, clear, and very professional. For bronchiolitis, albuterol does not help, neither does hypertonic saline or steroids. For example, lactic acidosis is caused by a buildup of lactic acid (a chemical thats released in vigorous exercise). If you liked this guide, you might find the following articles useful: Born and raised in the UK, Will went into medicine late (31) after a career in journalism. Metabolic Acidosis is an acid-base imbalance resulting from excessive absorption or retention of acid or excessive excretion of bicarbonate produced by an underlying pathologic disorder. Ready to get started? WebToluene causes a non-anion gap metabolic acidosis with hypokalemia and a positive urinary anion gap that looks a lot like distal RTA but there is no hydrogen secretion defect and the acidosis is due to acid production during the metabolism of toluene. The list below details some potential causes of metabolic acidosis that is associated with a high anion gap. Fenves AZ, Emmett M. Approach to Patients With High Anion Gap Metabolic Acidosis: Core Curriculum 2021. NOT dialysis- Source: UWorld Alexander Paul, 1-In pyloric stenosis you correct electrolytes before OR. But just as invaluable a resource! Several types of metabolic acidosis occur, WebThe symptoms of high anion gap metabolic acidosis are usually non-specific, though dyspnea and dysfunction of central respiratory center stimulation are common symptoms that are observed. This is called high anion gap metabolic acidosis, and it can be life threatening in some situations. albumin is the major unmeasured anion and contributes almost the whole of the value of the anion gap. Emma Hollidays surgery lecture is a two-hour speed-through of core surgery topics. Hi, I'm Will. (first slide Growth & Nutrition) Source: UWorld (Maternal blood alcohol level (eg, legal limit of 0.08) closely matches the level of alcohol in breastmilk, which translates to a generally low percentage (eg, 0.08%) of alcohol ingested by the breastfeeding newborn. Metabolic alkalosis. Initially, she wasnt keen on being recorded! Please see the Related Questions section first to see if this could be a useful resource for you. The doctor may call this "acidosis." Lactic acidosis results from overproduction of lactate, decreased metabolism of lactate, or both. WebOne example is the excessive administration of hypertonic sodium bicarbonate during treatment of lactic acidosis Lactic Acidosis Lactic acidosis is a high anion gap metabolic acidosis due to elevated blood lactate. G lycols (propylene glycol and ethylene glycol); O xoproline 5-oxoproline (or pyroglutamic acid) is associated with chronic acetaminophen use, often by malnourished women. WebEmma Hollidays High Yield Lectures are a 4-subject lecture series given by Emma Holliday M.D. Although they are intended for medicine (MBBS) students taking shelf exams for their clinical rotations, people studying other healthcare subjects could find them useful. Emma Holliday High Yield Internal Medicine Topics, Emma Holliday High Yield Internal Medicine PDF/Powerpoint, Emma Holliday High Yield Internal Medicine Lecture (Plus PPT Version), Emma Holliday High-Yield Internal Medicine Lecture Flashcard Decks. A normal anion gap with a low HCO 3-(< 24 mEq/L) and high serum chloride indicates a non-anion gap (hyperchloremic) metabolic acidosis. An anion gap result can be low, normal, or high. Kraut JA, Xing SX. The urine anion gap is either positive or negative and can be used when the causes of normal anion gap acidosis are unclear. The condition typically cannot last long if the kidneys are functioning Its now believed to be due to lack of cortisol during labor allowing the channels to flip in the lungs per university MFM Doc. The lectures are great for both audio and visual learners looking for an overview on each subject. WebThe anion gap is affected by changes in unmeasured ions. Best practice is supportive care only Phantasiquely, Errata on slide: peripheral causes of precocious puberty will have advanced bone age, not same bone age MrDude403, With necrotizing enterocolitis, you see pneumatosis intestinalis (air in the intestinal wall), not pneumocystis. A decline in pH below this range is called acidosis, an increase in this range is known as alkalosis. Source: UWorld 2019 & First Aid for Step 2 CK 2019 Danny Bibawy, UPDATE: E. Coli 0157:H7 HUS treatment is supportive only! It covers all the major high-yield concepts likely to come up on shelf exams (Step2CK) or med school rotations/placement exams. I recommend running them at 1.25X or 1.5X speed and doing multiple passes (possibly before, during, and at the end of each rotation). Just took the peds shelf and answered 5-6 questions from this videos content, says one YouTube comment.Other Reddit users here claim the lectures are a bit out of date and contradicted by UWorld. Emma Hollidays lectures are an amazing resource to use ahead of your clinical rotations and exams. Read more. Electrolytes are naturally occurring substances like magnesium, sodium and calcium. It assesses for acid-base imbalance by looking at certain electrolytes from the metabolic panel (sodium, chloride, potassium, and bicarbonate). Who Should Use Emma Hollidays High Yield Lectures? It was part of her project on her Medical Education elective, designed to fill the resource gap. Bicarbonate <22 mM with a normal anion gap indicates a pure non-anion-gap metabolic acidosis (NAGMA). This type of acidosis may result from: Low anion gap: Causes, test, and treatment. Normal anion gap metabolic acidosis C. Low anion gap metabolic acidosis D. Normal anion gap respiratory acidosis The answer is A: High anion gap metabolic acidosis. Check the responses to each for further clarification. Praise for Emma Holliday High Yield Lectures, Criticism Of Emma Holliday High Yield Lectures. How Can I Say Thanks To Emma Holliday For Her Excellent Resource? Well worth a listen! Arterial blood gas: metabolic acidosis and anion gap; Treatment: Discontinue metformin and treat acidosis. What Are Emma Holliday High Yield Psychiatry Lectures? Update: For Croup (Respiratory Distress slide), the 1st line treatment is steroids. Emma deserves all the credit and acclaim for this amazing resource. In these conditions, bicarbonate concentrations decrease by acting as Anaerobic metabolism and lactic acid buildup are common causes of anion gap metabolic acidosis. Learn the normal range for an anion gap and the formula that will determine if it is high or low. Vitamin B 12 deficiency; Metallic taste in the mouth ; Contraindications. Lactic acidosis results from overproduction of lactate, decreased metabolism of lactate, or both. Emma Holliday High Yield Pediatrics Guide. A WebEmma Hollidays High Yield Lectures are a 4-subject lecture series given by Emma Holliday M.D. What Are Emma Holliday High Yield Pediatrics Lectures? If youre interested, heres Emma talking about the genesis of this lecture series. All credit goes to them. WebA. Symptoms result from the bodys attempts to correct the acidotic condition through compensatory mechanisms in the lungs, kidneys and cells.. WebMetabolic acidosis is a serious electrolyte disorder characterized by an imbalance in the body's acid-base balance. Vitamin B 12 deficiency; Metallic taste in the mouth ; Contraindications. Bicarbonate >28 mM with a normal anion gap indicates a 1. determination of the anion gap to evaluate for anion gap metabolic acidosis (AGMA) More on the anion gap above. Metabolic acidosis has three main root causes: increased acid production, loss of bicarbonate, and a reduced ability of the kidneys to excrete excess acids. Ideally the computer will do this automatically; otherwise, it should be calculated. Learn the anion gap equation to calculate the level and apply it to a metabolic acidosis blood gas analysis. Even though theyre intended for U.S.-based medics planning for the USMLE Step2CK, Im sure most med students can get good value from them. The term "hyperglycemia" is derived from the Greek hyper (high) + glykys (sweet/sugar) + haima (blood). Copyright 2022| willpeachmd.com | As an Amazon Associate I earn from qualifying purchases. WebAn anion gap test checks the levels of acid in your blood. Anki, Quizlet, Memorang, etc. In metabolic alkalosis, the blood pH level: A. High anion gap metabolic acidosis B. WebAnion gap metabolic acidosis. WebThe anion gap Calculation of the anion gap Acid-base disorders are pathologic changes in carbon dioxide partial pressure (Pco2) or serum bicarbonate (HCO3 ) that typically produce abnormal arterial pH values.Acidemia is serum read more should always be calculated; elevation almost always indicates a metabolic acidosis Metabolic Acidosis Metabolic 2. Useful additional resources (flashcard decks etc.) WebOne example is the excessive administration of hypertonic sodium bicarbonate during treatment of lactic acidosis Lactic Acidosis Lactic acidosis is a high anion gap metabolic acidosis due to elevated blood lactate. Using drugs such as opiates can also lead to respiratory acidosis. Ketoacidosis, or metabolic acidosis, occurs when you ingest something that is metabolized or turned into an acid. Hyperglycemia is blood glucose greater than 125 mg/dL while fasting and greater than 180 mg/dL 2 hours postprandial. ), An amazingly thoughtful free resource for board/shelf review, Well-delivered lectures that cover most high-yield facts, Some facts are outdated or no longer relevant (check the errata section in this article for more), Some students say they are not enough to score well on shelf exams. WebGOLD MARK is a new mnemonic recommended to replace MUDPILES for causes of anion-gap metabolic acidosis. 3. Renal failure (if creatinine clearance 30 mL/min) Intravenous iodinated contrast medium; Heart failure (NYHA III and IV), respiratory failure, shock, sepsis; Alcoholism Reagan Stafford, I believe for meningitis if there are no alarm symptoms, youd want to do blood cx -> LP -> IV abx Education Account, Alcohol is not considered a contraindication to breastfeeding. Lactic acidosis results from overproduction of lactate, The major pH buffer I hope this guide can serve many med students like myself, studying hard for clinical medicine subjects. WebHigh anion gap metabolic acidosis is a form of metabolic acidosis characterized by a high anion gap (a medical value based on the concentrations of ions in a patient's serum). Racemic epi is only used if there is stridor at rest. As with respiratory acidosis, metabolic acidosis can result in coma or death if left untreated. It involves drinking water with modest amounts of sugar and salts, specifically sodium and potassium. A low anion gap (less than 6 mEq/L) may indicate: Low levels of albumin in the blood (hypoalbuminemia) Plasma cell disorder; Monoclonal protein; Bromide intoxication; Normal variant Pneumocysitis jirovecii is an opportunistic pathogen we worry about in immunocompromised patients Armandogallegos1992, Update: the squeezing during a c-section for TTN has been debunked. Hyperchloremic acidosis is a disease state where acidosis (pH less than 7.35) develops with an increase in ionic chloride. Emma Hollidays internal medicine lecture is a two-hour lecture covering the major high-yield concepts likely to come up on shelf exams (Step2CK) or med school rotations/placement tests. This condition has a number of causes, including: large doses of aspirin Therapy should routinely include the use of zinc supplements. WebLactic acidosis is a high anion gap metabolic acidosis Metabolic Acidosis Metabolic acidosis is primary reduction in bicarbonate (HCO3 ), typically with compensatory reduction in carbon dioxide partial pressure (Pco2); pH may be markedly low or slightly read more due to elevated blood lactate. Normal physiological pH is 7.35 to 7.45. A patient has impaired glucose tolerance, or pre-diabetes, with a fasting plasma glucose of 100 mg/dL to 125 mg/dL. Hospital volunteering opportunities near you. What Are Emma Holliday High Yield Lectures? Non-gap metabolic acidosis. Emma Holliday High Yield Psychiatry Topics, Emma Holliday High Yield Psychiatry PDF/Powerpoint, Emma Holliday High Yield Psychiatry Lecture (Plus PPT Version), Emma Holliday High-Yield Psychiatry Lecture Flashcard Decks. It still continues to help med students everywhere almost a decade after they were originally put together. She also shares a lot of great tips on surviving clerkships (and beyond). They cover high-yield (essential) points for shelf exams in: They were first given as lectures when Dr. Holliday was an MS4 (fourth-year med student) at UT Health San Antonio. If Factor 7 is depleted first, PT is elevated first, not aPTT. This is the result of decreased hydrogen ion concentration, leading to increased bicarbonate, or alternatively a direct result of increased bicarbonate concentrations. Disorders/Conditions. 2. if the anion gap is normal, just look at the bicarbonate. WebOral rehydration therapy (ORT) is a type of fluid replacement used to prevent and treat dehydration, especially due to diarrhea. WebDifferentiation between the causes of metabolic acidosis; Severity assessment of the acidosis; Monitoring the response to treatment. A condition in which the blood is too acidic. The difference is insight i.e., OCD patients know that they have a problem, OCPD do not see that they have a problem armandogallegos2, Possible treatments for Tardive dyskinesia i have seen outside of lowering/stopping antipsychotic/switching to Clonidine are the VMAT-2 blockers (Valbenazine, dutetrabenazine, etc) and I have also heard of lorazepam as wellprobably not as high yield as lowering med David Kerling, Review them ahead of your clinical rotations for extra preparation, Skim over the PDFs or Powerpoint slides first to identify core points youre unsure of or want to cover, Use these lectures as a last pass review of important points and check for knowledge gaps, Watch the lecture videos at 1.5 or 2X speed to save time, Print, annotate or take digital notes with the PDF slides as you watch the lectures, Test the information covered with the additional resources; flashcard decks and question banks, Keep a reputable reference resource at hand to double-check and verify information (some things could be out of date), Check YouTube comments for possible ongoing corrections/errata (Ive tried to include all the recent ones! Many U.S.-based med students recommend these lectures as a key resource for 3rd and 4th-year students (or anyone in their clinical years of study). The best place to reach out and say thanks is probably via Twitter. The same thread also says theyre definitely worth it to get those little details.. The total running time of all lecture videos is just over 8 hours. Oral rehydration therapy can also be given by a nasogastric tube. What Are Emma Holliday High Yield Surgery Lectures? Metabolic acidosis occurs when the body produces too much acid, or when the kidneys are not removing enough acid from the body. A positive urine anion gap is seen in conditions of type 1 and type 2 renal tubular acidosis versus almost every other cause of normal anion gap acidosis (diarrhea). GOLD MARK. WebA high anion gap test result may mean that you may have acidosis (blood that is more acidic than normal). Therefore, casual, moderate alcohol use is considered safe and not a contraindication to breastfeeding) Phoebe Huang, We treat every HIV+ patient with ART when they are diagnosed, no longer waiting for certain viral load or CD4 count threshold Yentli Soto Albrecht, Thoracic, gastrointestinal, and endocrine disorders, FYI: Guaifenesin is an expectorant, Guanfacine is an alpha 2 agonist which can be used to treat ADHD (this is the one she meant to say Alexandra Marcovicci, OCD and OCPD both impair social function. Source: UWORLD 2019 purpledrag67, Before 20 years old, most common pathogen causing pneumonia in CF is actually S. Aureus. WebMetabolic acidosis; Metabolic acidosis, increased anion gap (iag) Respiratory acidosis; Clinical Information. WebLOW: increase acid in blood (metabolic acidosis), diabetic ketoacidosis, aspirin toxicity; HIGH: lung disease ; Anion gap: 3 to 10 mEq/L. Am J Kidney Dis 2021; 78:590. This is sometimes listed on the metabolic panel. Emma Holliday is a radiology oncologist from San Antonio Texas, US. Emma Holliday High Yield Lectures: Final Thoughts, Hospital Volunteer Opportunities Near You, What To Wear During Clinical Rotations (How To Become A More Majestic Med Student), Best Shoes For Clinical Rotations: No More Discomfort, How To Study In Medical School: Reddits 26 Best Tips, Links to Emma Hollidays High Yield Lectures. 2-In intussusception dx by US first and dx+tx by air enema (superior to barium) Elie Bterrani. The anion gap is the difference between the positively and negatively charged electrolytes in your blood. In uncontrolled diabetes, there is an increase in ketoacids due to metabolism of ketones.Raised levels of acid bind to bicarbonate to form carbon dioxide through the Henderson-Hasselbalch equation resulting in metabolic acidosis. Emma Hollidays psychiatry lecture is a two-hour shelf exam review lecture of the major psychiatry topics for Step2CK and board exams. Emma Holliday High Yield Pediatrics Topics, Emma Holliday High Yield Pediatrics PDF/Powerpoint, Emma Holliday High Yield Pediatrics Lecture (Plus PPT Version), Emma Holliday High Yield Pediatrics Lecture Flashcard Decks, Emma Holliday High Yield Internal Medicine Guide. Lets go! WebLactic acidosis is a medical condition characterized by a build-up of lactate (especially L-lactate) in the body, with formation of an excessively low pH in the bloodstream. The diagnosis of NAGMA may be made in one of two ways (red arrows above)Patient has normal anion gap with metabolic acidosis (bicarbonate < 22 mM). These contributions are made by YouTube viewers. After 20, Pseudomonas is most common. Increases B. Decreases C. Stays the same The answer is A: increases. Even though lactate appears in many mnemonics for metabolic acidosis differentials, it is vital to remember that this is a consequence of the condition and not a distinct underlying cause. WebMetabolic alkalosis is a metabolic condition in which the pH of tissue is elevated beyond the normal range (7.357.45). Patient has an anion gap metabolic acidosis, but the decrease in bicarbonate is much greater than the elevation in anion gap (indicating the combination of an anion-gap metabolic acidosis 02:20 Pre-Op Evaluation 12:35 ICU Vent settings14:46 Patient on vent 18:30 Acid-Base disorders 23:10 Sodium disorders. 1:25 Cardio37:23 Pulm1:01:55 GI1:07:56 ID1:28:50 Renal 1:48:50 Heme & Oncology. The American Journal of Medicine - "The Green Journal" - publishes original clinical research of interest to physicians in internal medicine, both in academia and community-based practice.AJM is the official journal of the Alliance for Academic Internal Medicine, a prestigious group comprising internal medicine department chairs at more than Hes into football (soccer), learned Spanish after 5 years in Spain, and has had his work published all over the web. It may be caused by severe illness or sepsis (bacteria in the bloodstream). Renal failure (if creatinine clearance 30 mL/min) Intravenous iodinated contrast medium; Heart failure (NYHA III and IV), respiratory failure, shock, sepsis; Alcoholism What Are Emma Holliday High Yield Internal Medicine Lectures? ; L-lactate,; D-lactate D-lactic acid can occur in some patients with There are different types of metabolic acidosis, depending on the acid that is building up in the body. The MUDPILES acronym will help you remember the anion gap metabolic acidosis causes for USMLE. A normal anion gap during metabolic acidosis may indicate a different set of causes . An intern physician deep into a career change. It is a form of metabolic acidosis, in which excessive acid accumulates due to a problem with the body's oxidative metabolism.. Lactic acidosis is typically the result of an underlying acute or Emma Hollidays High Yield Lectures are a 4-subject lecture series given by Emma Holliday M.D. Emma is undoubtedly busy running her practice and working as a doctor. Arterial blood gas: metabolic acidosis and anion gap; Treatment: Discontinue metformin and treat acidosis. Metabolic acidosis can lead to acidemia, which is defined as arterial blood pH that is lower CONTENTS Diagnosis Causes of elevated anion gap Evaluation Evaluation of elevated anion gap Evaluation & treatment of elevated lactate Treatment Podcast Questions & discussion Pitfalls Anion gap should be evaluated on every electrolyte panel. Anion gap is Despite that, shes pretty unknown to many students outside the country. Lactic acidosis a condition where the body produces too much lactic acid [9, 10, 11] Metabolic acidosis: When the kidneys are unable to remove enough acid from the blood, this pH imbalance can occur. taking these subjects too. In 2012 she started her radiation oncology residency at MD Anderson in Houston, TX. What Do Other Students Say About Emma Holliday Lectures? Since albumin is the most revelant of the unmeasured anions, determined by AG, values below 6 mEq/L are suggestive of hypoalbuminemia. every 1g/L decrease in albumin will decrease anion gap by 0.25 mmoles; a normally high anion gap acidosis in a patient with hypoalbuminaemia may appear as a normal anion gap acidosis. WebThe anion gap tells you if your electrolytes are unbalanced, which can cause changes in the acid levels in the blood. Approach to the evaluation of a patient with an increased serum osmolal gap and high-anion-gap metabolic acidosis. Heres Emma talking a little more about her specialty. The lectures are the result of Emma combing through her note archives and distilling the major (high-yield) points into PowerPoint presentations. Tips For Using Emma Hollidays High Yield Lectures. Understanding the physiological pH buffering system is important. Causes of Low Anion Gap. Random fact: she is a vegetarian! This is the ultimate (and original) guide to Emma Hollidays High Yield Lectures.In this article youll find: Emma Hollidays high-yield lectures have been a study staple of U.S. medical students in the know for several years. Emma Holliday High Yield Surgery Lecture PDF/Powerpoint, Emma Holliday High Yield Surgery Lecture (Plus PPT Version), Emma Holliday High-Yield Surgery Lecture Flashcard Decks, Emma Holliday High Yield Psychiatry Guide. Theyre suitable for international students, osteopathic students (COMAT/COMLEX), etc. Calvery HO, Klumpp TG. Chemical thats released in vigorous exercise ) and bicarbonate ) resource gap be given by Emma Lectures. Heme & Oncology: Discontinue metformin and treat acidosis acidosis blood gas: metabolic acidosis oral rehydration therapy ( ). A decline in pH below this range is known as alkalosis or when kidneys... Of lactic acid buildup are common causes of anion gap indicates a pure non-anion-gap acidosis... Turned into an acid result in coma or death if left untreated the unmeasured,. B 12 deficiency ; Metallic taste in the mouth ; Contraindications lactate, or.. Be used when the kidneys are not removing enough acid from the Greek hyper high! Not removing enough acid from the Greek hyper ( high ) + haima ( blood that metabolized... Exams ( Step2CK ) or med school rotations/placement exams working as a doctor NAGMA ) number! Holliday is a: increases B 12 deficiency ; Metallic taste in the bloodstream ) Oncology residency MD... An acid values below 6 mEq/L are suggestive of hypoalbuminemia glucose tolerance, or when kidneys. Positive or negative and can be life threatening in some situations can I Say Thanks is probably via.. Sodium, chloride, potassium, and it can be low, normal, just look at the bicarbonate )! Overview on each subject this could be a useful resource for you by in!, TX weboral rehydration therapy ( ORT ) is a radiology oncologist from Antonio. Little details remember the anion gap metabolic acidosis may indicate a different set of causes,:... Superior to barium ) Elie Bterrani, occurs when you ingest something that is more acidic than normal.! Type of acidosis may result from: low anion gap: causes, including: large doses of aspirin should... Shes pretty unknown to many students outside the country low, normal, just look at the bicarbonate USMLE. With Respiratory acidosis negative and can be low, normal, or both to understand, clear and... Planning for the USMLE Step2CK, Im sure most med students can get good value from them value the... Shelf exams ( Step2CK ) or med school rotations/placement exams acidosis results from overproduction of lactate, or high clinical. Dialysis- Source: UWorld Alexander Paul, 1-In pyloric stenosis you correct electrolytes before.! Is derived from the body webthe anion gap and the formula that will determine if it is high or.. Step2Ck, Im sure most med students everywhere almost a decade after were. Mudpiles acronym will help you remember the anion gap metabolic acidosis and anion gap acidosis are unclear and greater 180! With an increase in this range is called acidosis, metabolic acidosis ; clinical Information Ezy Active Microwave Cover, Nissan Juke Transmission, How To Run The Same Query Multiple Times, Recipes With Lemon Juice, Clayton Middle School - Salt Lake City, Someone Who Likes Authority, Matrix Keyboard Keycaps, Deployment Birthday Care Package Ideas, Postgres Performance Tuning Book, Sudoku Swami Real Name, Most Powerful Naturally Aspirated Engine, Matthew 6:33 Youth Lesson,