11-Hidden Metabolic Acidosis with Normal ABG | Clinical Case |

🩺 *Acid-Base Disorders — Part 11: Clinical Case 2-1* Can a patient have a significant bicarbonate deficit despite nearly normal arterial blood gas values? In this case-based lecture, we analyze a patient with severe diarrhea, extracellular volume contraction, and an apparently normal acid-base profile. 📚 *Clinical Case:* A 25-year-old man presents with severe diarrhea and dehydration. Initial findings: Arterial pH: 7.39 HCO₃⁻: 24 mmol/L PCO₂: 39 mmHg Anion gap: 24 mEq/L Hematocrit: 60% Albumin: 8 g/dL 📚 *Topics Covered:* ✅ Initial ABG interpretation ✅ Diarrheal bicarbonate loss ✅ Severe extracellular volume contraction ✅ Hematocrit-based plasma volume estimation ✅ Total extracellular bicarbonate content ✅ Effects of elevated albumin on the anion gap ✅ Arterial vs. tissue respiratory acidosis ✅ Step-by-step physiological calculations ✅ Final diagnostic interpretation 🎯 Learn why acid-base diagnosis requires integration of clinical findings, fluid compartments, and laboratory measurements. 📖 Reference: Halperin, Goldstein & Kamel — Clinical Case 2-1. 👨‍⚕️ Dr. Bashar Qudah | @BasharQ26 #MetabolicAcidosis #ClinicalCase #ABGInterpretation #AcidBaseDisorders #BasharQ26