Yesterday I gave a great lecture on interpreting ABG results. I added a problems set for gap-gap analysis and added a section on the osmolar gap. I also improved the anion gap section with my new favorite nemonic. Forget PLUMSEEDS, forget MUDSLEEPS, forget MUDPILES. The new hotness is GOLD MARK:
- G Glycols
- O 5-Oxoproline (pyroglutamic acid)
- L L-Lactic acid
- D D-Lactic acid
- M Methanol
- A Aspirin
- R Renal failure
- K Ketoacidosis
This new nemonic was published in a letter in the Lancet (thanks vincent bourquin). I love that it drops the silliness of paraldehyde that no one uses anymore and drops isoniazid and iron which hardly ever cause an anion gap.
I also stumbled across a cool article on the sensitivity of the anion gap for lactic acidosis. Surprisingly an anion gap is only found in 58% of patients with an anion gap.
Additionally I cleaned up a bunch of the lecture. I still have not reformatted it for the iPhone so the handout is traditional 8.5×11 without a booklet form.
The Lancet
2008 vol. 372 (9642) pp. 892-892
great. thanks for the reference!