ether
Forum Newbie
Topics: 2
Posts: 7
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What is the acid base analysis of the following patient?
82 yo male presents with pH 7.2, HCO3 20 paCO2 20 paO2 90. His weight is 70 Kg and height 172cm.
What do you think is the possible differential diagnosis?
For more information floeos.com (free)
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| ManuNastai
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he's got a partially compensated metabolic acidosis
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| star1
Forum Guru
Topics: 93
Posts: 827
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This is mixed Disorder... Metabolic acidosis , It didnt read this section of step2 so any body please clerify .... what I know is a formula ...
for PaCO2 compensation ..... =1.5 ( HCO3) + 8
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| ether
Forum Newbie
Topics: 2
Posts: 7
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IMAGINE an advanced medical "calculator" which can:
1. Analyze acid-base/anion gap/delta-delta/osmolarities
2. Analyze electrolyte disturbances by following algorithms (e.g. hyponatremia)
3. Doing all the possible medical calculations from the above data (e.g. from acid-base data will calculate Aa gradient etc with out being asked.
4. Generating realtime differential diagnosis and adding a score to a designated diagnosis based on the number of the abnormalities found!
5. Doing all these functions, by just adding Once the numbers
6. And finally generating a thorough acid base analysis in less than 1 minute, realtime.
So here it is for this case:
Calculations by M.I.N.D.
-------------------------------
Primary acid base disturbance: Metabolic acidosis -
Secondary dusturbance : Respiratory alkalosis
BMI: 23.6614386 -- Body Mass Index is normal.
A-a gradient: 34.73 Abnormal: A-a grad. for a normal 82 yo patient on 21% O2 is: 24.5
TBW: 42 L Basal Energy Exp: 1479.27 kcal/d Body Surface Area: 1.8251187 sq. meters
Calculated Sat 02: 0.96944771%
-------------------------------
Snap differential
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1. Metabolic acidosis - , , , , Detected, MIND score: 5
2. Respiratory alkalosis - , , , , Detected, MIND score: 5
3. Pulmonary embolism: - R. Alk., , R/O Pulm. embolism: Abnormal A-a grad., R. Alk., MIND score: 4
4. Diarrhea: - Met. Acid., MIND score: 1
5. RTA I: - Met. Acid., MIND score: 1
6. RTA II.: - Met. Acid., MIND score: 1
7. Fanconi: - Met. Acid., MIND score: 1
8. Addison's disease: - Met. Acid., MIND score: 1
9. K sparing diuretics: - Met. Acid., MIND score: 1
10. RTA IV: - Met. Acid., MIND score: 1
11. Hyperalimentation: - Met. Acid., MIND score: 1
12. Salicilate poisoning: - R. Alk., MIND score: 1
13. Acetazolamide abuse: - Met. Acid., MIND score: 1
14. Sepsis: - R. Alk., MIND score: 1
16. CNS lesion: - R. Alk., MIND score: 1
17. Anxiety: - R. Alk., MIND score: 1
18. Pain disorder: - R. Alk., MIND score: 1
Download M.I.N.D. at www.floeos.com and see yourself! It is completely free. I believe is probably the best medical calculator. (Only for PC and Mac, not for pocket pc due it's realtime nature)
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| ether
Forum Newbie
Topics: 2
Posts: 7
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___________________________________________________________________________ _______________
M.I.N.D. e-consultation
(c) 2007, Floeos solutions *** Registered to : Beta1 tester
___________________________________________________________________________ _______________
Printed on: May 04, 2007 Time: 18:54:12
1. PATIENT DATA
--------------------------------------------------------------------------- -----------------------------------------------------
Patient's name: Age: 82 Gender: -Please adhere to HIPAA regulations -
Patient code:
Admission date:
Department: Beta1 version does not support this function
2. MEDICAL CALCULATIONS
--------------------------------------------------------------------------- -----------------------------------------------------
Body Mass Index -- BMI: 23.6614386 Kg/square meters.
Body Mass Index is normal.
Calculated serum osmolality : 0
Measured serum osmolality: 0
Osmolar gap: 0 -- Normal FENA: 0%
GFR (Crockroft-Gault formula): 0 ml/min -- Normal GFR for s: --
F.E.NA: 0%
A-a gradient: 34.73. Normal A-a grad. for this patient age/fio2: 24.5. A-a grad. is Abnormal
3. ACID-BASE ANALYSIS / UNDERLYING DISORDER DETECTION
--------------------------------------------------------------------------- -----------------------------------------------------
Anion Gap: 0. [ Anion Gap calculation = Na+ - (Cl- + HCO3-) ]
Delta Delta: 0. [Delta Delta calculation = AnionGap - 12 + HCO3-]
>> NOT CONFIRMED. You provided . M.I.N.D calculations point to Metabolic acidosis.
! Anion gap CANNOT be calculated. Insufficient input data...
>> No secondary metabolic acid base abnormality detected.
3.A. COMPENSATION ANALYSIS
-------------------------------------------
>> Respiratory Alkalosis may be hidden under the expected compensation for Metabolic acidosis.
Estimated dCO2= 1.8* dHCO3 +5. Anticipated paCO2 is: 27.8. Actual paCO2 is: 20.
3.B. SUMMARY
----------------------
>> Primary Abnormality: Metabolic acidosis/ Secondary / Underlying: Respiratory alkalosis because compensation is : Inappropriate
RESPIRATORY ALKALOSIS ANALYSIS
-----------------------------------------------
Diagnoses to consider in this setting
** Pulmonary embolism
** Sepsis/Infection
** Pneumonia
Salicilate toxicity
CNS Lesion
Anxiety disorter (Hyperventilation)
Pain/Fear
Congestive heart failure (CHF)
High Altitute
Pregnancy
Liver failure
Hyperthyroidism
Over compensation for primary acidosis
METABOLIC ACIDOSIS ANALYSIS
-----------------------------------------------------
>> Metabolic acidosis and hypokalemia. Serum K+ will further help narrowing down the differential
Diagnoses to consider in this setting:
Acetazolamide
RTA type I or II
Diarrhea (HCO3 loss)
Fanconi syndrome
K+ sparing diuretics
RTA type I or II
Diarrhea (HCO3 loss)
Fanconi syndrome
M.I.N.D PROBABILITY STRATIFICATION
--------------------------------------------------------------------------- -----------------------------------------------------
| 1. Metabolic acidosis - , , , , Detected, MIND score: 5
| 2. Respiratory alkalosis - , , , , Detected, MIND score: 5
| 3. Pulmonary embolism: - R. Alk., , R/O Pulm. embolism: Abnormal A-a grad., R. Alk., MIND score: 4
| 4. Diarrhea: - Met. Acid., MIND score: 1
| 5. RTA I: - Met. Acid., MIND score: 1
| 6. RTA II.: - Met. Acid., MIND score: 1
| 7. Fanconi: - Met. Acid., MIND score: 1
| 8. Addison's disease: - Met. Acid., MIND score: 1
| 9. K sparing diuretics: - Met. Acid., MIND score: 1
| 10. RTA IV: - Met. Acid., MIND score: 1
| 11. Hyperalimentation: - Met. Acid., MIND score: 1
| 12. Salicilate poisoning: - R. Alk., MIND score: 1
| 13. Acetazolamide abuse: - Met. Acid., MIND score: 1
| 14. Sepsis: - R. Alk., MIND score: 1
| 16. CNS lesion: - R. Alk., MIND score: 1
| 17. Anxiety: - R. Alk., MIND score: 1
| 18. Pain disorder: - R. Alk., MIND score: 1
| 19. CHF: - R. Alk., MIND score: 1
| 20. Altitude sickness: - R. Alk., MIND score: 1
| 21. Pregnancy: - R. Alk., MIND score: 1
| 22. Liver failure: - R. Alk., MIND score: 1
| 23. Hyperthyroidism: - R. Alk., MIND score: 1
| 24. Overcompensated 1o acidosis: - R. Alk., MIND score: 1
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--
___________________________________________________________________________ _______________
Report review: code: May 04, 2007
___________________________________________________________________________ _______________
DATA ENTERED
Primary abnormality : -- 7.2 | 20 | 20 | 90 on 21% O2, Patm: 760
0 | 0 | 0 /
________________0
0 | 20 | 0 \
Serum Osmolarity: 0
Serum Ca: 0 Ionized Ca: 0 PTH: 0 Mg: 0 Phosphate: 0 Albumin: 0 Total protein 0
Urine volume: 0 cc - osmolarity: 0 mOsm UNa: 0 U K: 0 U Cl: 0 U HCO3: 0
Patient was reported to be and blood pressure to be .
Value of 0 corresponds to N/A data.
<>
Floeos solutions. (c) 2007
*** Disclaimer : User recognizes that the M.I.N.D consultation software is to be used only as a reference aid. It is not intended
to be a substitute for the exercise of professional judgment. Information on the M.I.N.D consultation software used also some
third party sources. Medicine is an ever-changing science. In view of the possibility of human error or changes in medical science
users are advised to confirm the information provided through M.I.N.D consultation software through independent sources. Users should
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Users must always seek professional opinion for the related medical condition, and to discuss information obtained from M.I.N.D consultation
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---
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| ether
Forum Newbie
Topics: 2
Posts: 7
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This is an advanced medical calculator which is 100% free.
You can use it as an aid to your acid-base / electrolyte problems but most importantly you can create e-consultations in a snap in your daily life as a resident, save time (and lives) and expanding your differential insight by just adding some numbers in seconds.
Enjoy,
100% free.
We are giving it free at www.floeos.com to learn from the experience of the users and get feedback.
www.floeos.com
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