Memory aid.... See the Two Peaks in the "M" for Metabolic? They Point in the same direction. Just remember same direction...Metabolic, the other thing- Respiratory is just opposite to this. Never forget. The cheat sheet is always there.
Thanks for such a great explanation. I wonder as doctors we use our reasoning and creative mind to a minimum compared to majority of professions who use is to the maximum, what we mainly do is cramming. All we require is a good memory.
sir,its very clear on how to diagnose the metabolic or acidic types and its acute and chronic situations.. but im still having problem on commenting whether the situation is compensated or uncompensated?could you briefly explain please??
The videos are not excellent because the author is a good doctor; they are excellent because he is also a good teacher because he can understand the level of understanding of a student.
If you do answer questions here, or anyone else, who knows - if you have increased CO2 due to lung obstruction in any form, and thus blood p.H reduces as CO2 binds to water in blood to make H2CO3 carbonic acid and dissociates as a free H+ proton, how does the kidney HCO3 help compensate ? In my head, high blood CO2 might cause an increase in H+ protons in the blood, which could bind to the kidney HCO3, as H2CO3, which if it dissociated into H+, and CO2, could increase the CO2 & H+ in the blood, which seems to create a domino effect ?!! Is my reasoning faulty ? Does the kidney somehow stop H2CO3 from dissociating ? But if the kidney is essentially creating even more CO2 & H+ protons, how is the kidney function actually helping, if the CO2 cannot leave via the lungs ? Wouldn't we have to try to pharmaceutically reduce kidney biproduction of CO2 & focus on removing lung obstruction via antibiotics, anti-inflammatories, diuretic drainers of fluid, and by lowering tidal ventilation to minimum threshold and increase speed of inhalation in order to reduce CO2 build up and increase relative exhalation time ? Also, if CO2 in the blood is low, then how can kidney HCO3 create CO2 to raise blood CO2, without the presence of H+ ions, to make a bond then a dissociation into H2O and CO2 ? I am currently lost in the dynamics of this and I am sure there must be many other cations and anions at play that cause kidneys to produce CO2 for the blood and also to mop up excess CO2 that are not discussed here.
Hi Dr, i read that for every 1 meq/L fall in HCO3 the CO2 will decrease by 1.2 for metabolic acidosis and for every 1 meq/L rise in HCO3 the CO2 will increase by 0.7 for metabolic alkalosis. Is this correct?
Idk about the values by which they change ...but definitely in metabolic acidosis the fall in the hco3- and pco2 is not the same because then the ph won't decrease
Just cram. If you wanted to learn all this stuff you should have been an engineer or scientist. In an acute setting we doctor mainly use our crammed knowledge. We don't have to be intelligent to be a good doctor. You can be a genius but it doesn't mea you will be a good doctor. Cramming is the essence of this job.
who can tell me about the winters rules,where i found them,i want to read some article.I dont understand why in acidosis the HCO3 is down by 1 and the compensatory drops 1 by Pco2.WHy not HCO3 drops 2 and Pco2 by 3 ,this i want to understand.
King Sam Just a bit of help in case you haven’t figured that out, this is a tool to help us differentiate between cases such as asthma that is acute (because asthma can cause pCO2 to rise), while COPD, is by definition a chronic case and thus this difference helps us diagnose and treat.
Memory aid.... See the Two Peaks in the "M" for Metabolic? They Point in the same direction. Just remember same direction...Metabolic, the other thing- Respiratory is just opposite to this. Never forget. The cheat sheet is always there.
Best explanation I've heard in regards to compensation. Thank you!
DR S. you are the best...I teach nursing and you have helped me understand this elusive subject so much better..thank you
Amazingly clear !! Love these videos. Thank you so much.
you make this look fun man
kinda motivated to be an internist now lol
Thanks for such a great explanation. I wonder as doctors we use our reasoning and creative mind to a minimum compared to majority of professions who use is to the maximum, what we mainly do is cramming. All we require is a good memory.
the best video ever on acid base lecture.
dude......u saved me with this awesome lecture
sir,its very clear on how to diagnose the metabolic or acidic types and its acute and chronic situations.. but im still having problem on commenting whether the situation is compensated or uncompensated?could you briefly explain please??
u r an amazing teacher.greetings from china
You really are good doctor! Now I understand. Thank you!
The videos are not excellent because the author is a good doctor; they are excellent because he is also a good teacher because he can understand the level of understanding of a student.
I agree with you, Dr. Whitham. Teaching is a skill and Dr. Seheult has it.
Very rad lecture!
If you do answer questions here, or anyone else, who knows - if you have increased CO2 due to lung obstruction in any form, and thus blood p.H reduces as CO2 binds to water in blood to make H2CO3 carbonic acid and dissociates as a free H+ proton, how does the kidney HCO3 help compensate ? In my head, high blood CO2 might cause an increase in H+ protons in the blood, which could bind to the kidney HCO3, as H2CO3, which if it dissociated into H+, and CO2, could increase the CO2 & H+ in the blood, which seems to create a domino effect ?!! Is my reasoning faulty ? Does the kidney somehow stop H2CO3 from dissociating ? But if the kidney is essentially creating even more CO2 & H+ protons, how is the kidney function actually helping, if the CO2 cannot leave via the lungs ? Wouldn't we have to try to pharmaceutically reduce kidney biproduction of CO2 & focus on removing lung obstruction via antibiotics, anti-inflammatories, diuretic drainers of fluid, and by lowering tidal ventilation to minimum threshold and increase speed of inhalation in order to reduce CO2 build up and increase relative exhalation time ? Also, if CO2 in the blood is low, then how can kidney HCO3 create CO2 to raise blood CO2, without the presence of H+ ions, to make a bond then a dissociation into H2O and CO2 ? I am currently lost in the dynamics of this and I am sure there must be many other cations and anions at play that cause kidneys to produce CO2 for the blood and also to mop up excess CO2 that are not discussed here.
Hi Dr, i read that for every 1 meq/L fall in HCO3 the CO2 will decrease by 1.2 for metabolic acidosis and for every 1 meq/L rise in HCO3 the CO2 will increase by 0.7 for metabolic alkalosis. Is this correct?
Idk about the values by which they change ...but definitely in metabolic acidosis the fall in the hco3- and pco2 is not the same because then the ph won't decrease
yes, they represent what the body does all at the same time.
These are brilliant! thanks heaps!!!!
Thank you so much 🌸
Hi, can you please explain how the maths work at the end of the video? I don't quite get the method :/
Just cram. If you wanted to learn all this stuff you should have been an engineer or scientist. In an acute setting we doctor mainly use our crammed knowledge. We don't have to be intelligent to be a good doctor. You can be a genius but it doesn't mea you will be a good doctor. Cramming is the essence of this job.
informative.....THANK U !
Amazing 🤩
I like winter chart
we cannot feeling the time how passe when we see your explication video
great
First time its ever been that you explained something and I didn't quite get it.. : (
lol.... did anybody get the Risperdal commercial? killing 2 birds over here!
who can tell me about the winters rules,where i found them,i want to read some article.I dont understand why in acidosis the HCO3 is down by 1 and the compensatory drops 1 by Pco2.WHy not HCO3 drops 2 and Pco2 by 3 ,this i want to understand.
rusu romica maybe because there are different speeds of getting rid of HCO3 and CO2...
rusu romica please watch the videos starting from the first video.... Then u vl understand very clearly
i understand it but i dnt know whats the point of it
same here.... i dont know why we need to know that was acute or chronic respratoric acidosis, compensated or not... no point
King Sam Just a bit of help in case you haven’t figured that out, this is a tool to help us differentiate between cases such as asthma that is acute (because asthma can cause pCO2 to rise), while COPD, is by definition a chronic case and thus this difference helps us diagnose and treat.
Ugh... I didn't understand this...