The serum anion gap is a calculated laboratory value used to evaluate the etiolo

Question

The serum anion gap is a calculated laboratory value used to evaluate the etiology of acid-base disorders. Recall that the anion gap is represented with the following equation: Anion gap = ([Na+] + [K+]) - ([Cl-] + [HCO3-]) Note that many people do not include the concentration of K+ in their calculation because the body controls potassium concentration very tightly and it rarely varies outside the range of 3.5-4.5 mEq/L; if one uses K+ in the calculation, the “normal” value is up to 16; without including K+, the normal value for the anion gap is up to 12. An increased anion gap would be consistent with which of the following?

The body has a net neutral charge, but the anions we measure have been replaced by anions other than Cl- and HCO3-.

The body has a net neutral charge, but the cations we measure have been replaced by cations other than Na+ and K+.

There are now more anionic equivalents than cationic equivalents, and the body has a net negative charge.

There are now more cationic equivalents than anionic equivalents, and the body has a net positive charge.

Explanation / Answer

ANSWER : An increased serum anion gap indicates that blood has low pH than normal value (7.4 to 7.8) due to retention of negatively charged ions (anion) or acidic protein.It is occured in the cases of diabetes and metabolic acidosis where ketone are metabolised into ketoacids and Bicarbonate ions decrease by these buffer acids and HCO3- reduced due to consuming by a unmeasured cation H+ via buffer action. So High anion gap is produced.

An anion gap is also produced by many unmeasured ions ( besides Na+ and K+) those present in the blood serum such as cation ( ca++ and mg++ )and anion(PO4 - - and SO4- -) but these are not used as serum anion calculator. These ions also play an important role in acid- base detection with Na+ and K+ or Cl- and HCO3- in blood serum and keep maintain a normal pH level.

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