| 11. | High anion gap metabolic acidosis is caused generally by the body producing too much acid or not producing enough bicarbonate.
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| 12. | For a list of the common causes of this change in bicarbonate or chloride, see normal anion gap acidosis.
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| 13. | These " unmeasured " ions are mostly anions, which is why the value is called the " anion gap ."
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| 14. | Laboratory errors need to be ruled out whenever anion gap calculations lead to results that do not fit the clinical picture.
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| 15. | The anion gap is sometimes reduced in multiple myeloma, where there is an increase in plasma IgG ( paraproteinaemia ).
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| 16. | Hypoalbuminemia can mask a mild elevation of the anion gap, resulting in failure to detect an accumulation of unmeasured anions.
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| 17. | And reflects either an increase in the anion gap or a decrease in the bicarbonate concentration ( [ HCO3?] ).
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| 18. | The anion gap can be spuriously normal in sampling errors of the sodium level, e . g . in extreme hypertriglyceridemia.
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| 19. | Loss of bicarbonate-rich pancreatic fluid via a pancreatic fistula can result in a hyperchloraemic or normal anion gap metabolic acidosis.
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| 20. | In normal health there are more measurable cations compared to measurable anions in the serum; therefore, the anion gap is usually positive.
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