High Anion Gap Metabolic Acidosis

Overview

4.6 out of 5 (17 Reviews)

Credits

1.00

Post Assessment Questions

5

Start Date

1 Jan 2021

Last Review Date

7 Aug 2023

Expiration Date

31 Dec 2023

Estimated Time To Finish

60 Minutes


 
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Activity Description

High anion gap metabolic acidosis (HAGMA) is a type of metabolic acidosis. Differentiation of acidosis into a particular subtype, whether high anion gap metabolic acidosis or non-anion gap metabolic acidosis aids in the determination of the etiology and hence appropriate treatment. First, to determine whether there is a high anion gap, the anion gap must be calculated. However, in patients with abnormal levels of albumin this must be corrected. If the corrected anion gap is greater than 12, this suggests an increased presence of unmeasured anions. Subsequently, the osmolar gap should be calculated to screen for the presence of alcohols, and ethanol, acetaminophen, lactate, salicylic acid, creatinine, and ketones should be measured. Additional testing includes arterial or venous blood gas, urinalysis, complete blood count, and evaluation of concomitant respiratory or metabolic disturbances. Calculating the delta/delta ratio of anion gap and bicarbonate can aid in this. Checking for D-lactate would be appropriate in a patient with short gut syndrome (post gastric-bypass surgery), as delivery of a large amount of carbohydrate to the colon could promote bacterial secretion of said chemical not typically tested for. EKG could detect changes caused by abnormal electrolytes, and abdominal radiography could be employed to evaluate for renal stones or iron ingestion. This activity describes the pathophysiology, evaluation, and management of high anion gap metabolic acidosis and highlights the role of the interprofessional team in enhancing care delivery for affected patients.

Target Audience

This activity has been designed to meet the educational needs of physicians.

Learning Objectives

At the conclusion of this activity, the learner will be better able to:

  • Describe the causes of high anion gap metabolic acidosis.
  • Summarize the treatment options for high anion gap metabolic acidosis.
  • Explain the pathophysiology of high anion gap metabolic acidosis.
  • Explain the importance of enhancing coordination amongst interprofessional team members to improve outcomes for patients with high anion gap metabolic acidosis.

Disclosures

The Campbell University Jerry M. Wallace School of Osteopathic Medicine (CUSOM) requires instructors, planners, managers, and other individuals who are in a position to control the content of this activity to disclose any real or apparent conflict of interest they or their immediate family may have as related to the content of this activity. All identified conflicts of interest are thoroughly vetted by CUSOM for resolution, to ensure fair balance, scientific objectivity of studies mentioned in the materials or used as the basis for content, and appropriateness of patient care recommendations.

CUSOM will identify, review, and resolve all conflicts of interest that faculty, authors, activity directors, planners, managers, peer reviewers, or relevant staff disclose prior to an educational activity being delivered to learners. Disclosure of a relationship is not intended to suggest or condone bias in any presentation but is made to provide participants with information that might be of potential importance to their evaluation of a presentation. Disclosure information for authors, editors, planners, peer reviewers, and/or relevant staff is provided with this activity.

Continuing Education Accreditation Information

 

 

The Campbell University Jerry M. Wallace School of Osteopathic Medicine (CUSOM) is accredited by the American Osteopathic Association to provide osteopathic continuing medical education for physicians. CUSOM designates this enduring material for a maximum of 1.00 AOA Category 1 B Credits and will report CME credits commensurate with the extent of the physician's participation in the activity.

Cancellation Policy: Cancellations must be received in writing and a money back guarantee is provided if not completely satisfied.

  • StatPearls and CUSOM reserve the right to cancel any course due to unforeseen circumstances. StatPearls and CUSOM will not be responsible for other expenses incurred by the participant in the unlikely event that the program is canceled.

Equal Opportunity

  • StatPearls and CUSOM are Equal Opportunity / Affirmative Action / Equal Access Institutions. 

Medium or Media Used:

  • Computer Requirements:  Internet Access
  • E-mail Address

Instructions for Credit

  1. Register for the activity and create a StatPearls login.     
  2. Review the required accreditation information:  Target audience, learning objectives and disclosure information.
  3. Complete the entire self-study activity.
  4. Complete the post-test assessments.
  5. Successfully pass the post-test with a minimum score of 100%.
  6. Complete the evaluation form.
  7. Obtain a certificate.

StatPearls and CUSOM adheres to AOA Standards regarding commercial support of continuing medical education. It is the policy of StatPearls and Campbell that the faculty and planning committee disclose real or apparent conflicts of interest relating to the topics of this educational activity, that relevant conflict(s) of interest are resolved and also that authors and editors will disclose any unlabeled/unapproved use of drug(s) or device(s) during their presentation. Detailed disclosure will be made prior to starting the activity.

The information provided at this CME/CE activity is for continuing education purposes only and is not meant to substitute for the independent medical/clinical judgment of a healthcare provider relative to diagnostic and treatment options of a specific patient’s medical condition.

This course is intended for osteopathic physicians who wish to earn AOA CME credit. Take this version of the course to ensure you receive appropriate credit.

 

 
 

Reviews

Mrs W. on 8/2/2021

sharon s. on 11/6/2021

Gibi G. on 11/22/2021

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