Metabolic Alkalosis (ABG Interpretation - Lesson 10)

A lecture on the differential diagnosis of a metabolic alkalosis, focusing on contraction alkalosis, loop and thiazide diuretics, mineralocorticoid excess, and hypokalemia. Also covered are Barrter, Gitelman, and Liddle syndromes, and licorice toxicity.

[ayeshasiddiqua]

12 years ahve passed, still this video is the best one explaining alkalosis, hats off to u

[StrongMed]

MrBhotu, I'm glad you have enjoyed the videos. I'm working on the remaining lectures of the ABG series as fast as I can, but unfortunately I don't have time built into my work schedule for this, so I can only do a little here and there. I hope to finish ABG lectures 11-20 by mid summer.

[StrongMed]

Lectures 11-15 are still coming. I was getting a little acid-base fatigued so decided to mix it up with some oxygenation for a couple lectures.

[wahibaramtani]

Hi, I agree with Asha Krishnaq who ask about renal failure because after all these lectures about ABG, we are almost ready to digest a not easy topic like Kidney disease..
I really enjoy these lectures, i feel like I can master evrything after that now

[aasemahsan]

2:50 Contraction alkalosis

8:09 Diuretics
-Volume contraction

10:27 Vomitting
Nasogastric suction

10:52 Mineralocorticoid excess

15:31 Hypokalemia

16:07 Milk-Alkali syndrome

16:58 Bartter & Gitelman syndrome

[achantihari]

great lectures sir, they are presented just the way anybody understands! thank you very much....
looking for the lectures 11 to 15... hope you have not forgotten them!(as 16 and 17th lectures are already uploaded).

[sunving]

Thank you Dr Eric Strong. Good lecture.

[nittijain]

awesome videos ...please upload the later parts....i am starving to see them dr eric...excellent presentation is real teaching ....many many thanks sir ...looking for parts on lecture 11 and onwards

[maliq]

What does hypercalcaemia have to do with metabolic alkalosis

[MikeBirkhead]

Thank you for your Lectures!
I know, from a previous lecture, that you dislike mnemonics. However, I wonder if there is a "Best" one for non-anion gap acidosis? 
The one I found, which I like (so far), is ABCD
A - Addisons
B - Bicarb Loss
C - Chloride Excess
D - Drugs
  Bicarb loss covers RTA (which gets me thinking of all types of RTA), Diarrhea, and Fistula
  Chloride excess covers the infusion of saline, etc. 

Your thoughts?

[mustakeeme]

thank you Mr. Strong, I like this lecture most.

[emanmahmoud]

many thanks 4 you really great work and in a very simple way .
I need you to also add how to treat at the end of these treasures lectures

[marebearzzz]

this is perfect, just what i needed! thank you :)

[AliRaza-roev]

What does urinary chloride levels has to do with metabolic alkalosis?

What makes it chloride resistant or chloride responsive?

[rdance]

I'm carnivore and don't eat carbs at all. ZERO carbs. Recently, I was sick with a virus. Just before, what I thought was full recovery, I became very weak. I suddenly needed sugar. I ate three packets of sugar and a Snickers Bar and soon felt better. When I got home, I ate two bowls of icecream. The next day, I was still a little weak so I had a small bowl of icecream and a prtein shake. Less than an hour later, I was in the Emergency Room. There, I was given three IV bags and two big Potassium pills. I was told that my Potassium was low, which I found strange because I salt my meat with a 50/50 blend of NaCl and Potassium Citrate. I actually had an electrlyte drink that morning. My discharge papers say Accute Respiratory Alkalosis but I can't help but think that it was more due to my etreme insulin sensitivity and my sugar intake. I wasn't haveing diarrhea and only vomited once. Potassium being low makes me think that it wasn't Milk-Alkali Syndrome but all that icecream that I consumed makes me wonder. 3 weeks prior, my Potassium was 4.9.

[vfine]

Hi Eric, Thanks for the nice well put together talk, I wonder if you can make a comment about treatment of Metabolic Alkalosis where no reversible cause is obvious or when it is very Severe? What about using Acetazolamide to mitigate the situation in severe cases. Many Thanks

[TheSpades]

Dr. Strong, thank you for answering my previous question. I have another question that maybe you would be able to answer. In response to low blood pressure, why does ATII and aldosterone increase H+ secretion and HCO3- reabsorption respectively? It seems odd to me that pH is addressed in conjunction with blood pressure. It seems to me that increasing pH would have little to no effect on increasing blood volume.

[طارقممدوح-ظف]

what is the relation between metabolic alkalosis and renal failure

[sepehralaie]

I have a question, when someone uses loop or thiazide duretics it prevents sodium and water reabsorbtion and so increases the tubular flow to macula densa cells, so macula densa cells should falsely sense an Increased GFR and decrease Renin secretion results in decreased aldosteron and Ag2.whay we seeing oposite to that?

[TheGreatSniper]

Great lecture! Are you considering including treatment options for metabolic alkalosis aswell?