Dominate acid-base disturbances with the wisdom of @kidney_boy aka Joel Topf, MD, Chief of Nephrology at Kashlak Memorial Hospital.  Master his 5 key steps for interpreting acid-base disorders and decode any ABG, VBG, and BMP to find the primary disorder, and any other disorders tucked away in the ABG! Plus: Henderson-Hasselbach and pH simplified; the anion gap, should your correct it?; choice of IV fluid; osmolar gaps, methanol, ethylene glycol, isopropyl alcohol; and how metabolic disorders are like a boy band. Be sure to follow along the Dr. Topf’s brilliant acid-base powerpoint. Written and produced by Joel Topf MD, Shreya Trivedi MD, Xavi Jimenez MD; Images by Hannah Abrams; Edited by Matthew Watto MD Full show notes available at http://thecurbsiders.com/podcast Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.  Time Stamps 00:00 Announcement 01:00 Disclaimer 01:34 Intro 02:45 The setup and guest bio 03:15 How does Dr Topf compensate for difficulty 07:10 What has helped Dr Topf become successful as an educator 10:40 With which electrolyte do you most closely identify? 14:05 Picks of the week 16:05 Nephmadness explained 19:50 Joel’s big picture look at acid base 22:17 Acid base and logorhythmic scale 24:28 A caution about ABGs 27:23 Clinical case from Kashlak Memorial Hospital 28:05 Misinterpretation of low bicarb on a metabolic panel 29:20 Step 1 of acid base 32:00 Metabolic disorders and One Direction 35:15 Acidemia vs acidosis; alkalemia vs alkalosis 37:52 Compensation for acid base disorders 40:45 ABG apps and analyzers 42:40 Step 2 Is there a second primary disorder? Use equations for determining if compensation is appropriate. 51:31 How to determine if respiratory compensation is acute or chronic 54:26 Step 3 The anion gap 57:21 Correcting the anion gap 60:33 What causes a low anion gap? 63:58 Anion gap acidosis 66:05 GOLDMARK 69:15 Step 4 Is there an osmolar gap? 71:48 Toxic ingestions: Methanol, ethylene glycol, and isopropyl alcohol 76:15 Calculating the osmolar gap 79:08 Step 5 Gap-gap calculation aka “the bicarbonate before” 85:05 Choice of IV crystalloid fluid and when to use a bicarbonate drip 88:15 Bicarbonate in DKA 90:18 NephMadness plug 91:10 Outro Tags: acid, base, anion gap, metabolic, respiratory, toxic alcohol, goldmark, mudpiles, albumin, acidosis, alkalosis, compensation, nephrology,  Henderson-Hasselbalch, equation, ABG, VBG, bicarbonate, pCO2, assistant, care, doctor, education, family, foam, foamed, health, hospitalist, hospital, internal, internist, meded, medical, medicine, nurse, practitioner, professional, primary, physician, resident, student