Milk 'does the body good'

Today we reviewed how to interpret a blood gas. There are many ways to do this but the approach generally follows a few simply steps....here is an example:

6 simple steps…

1. What is the pH?
2. Is the primary disturbance respiratory or metabolic?
3. Is there appropriate compensation?
4. If this is a metabolic acidosis is there an anion gap?

• what is the delta – delta?
• is there an osmolar gap?

5. what is the A-a gradient?

We also had a brief discussion of 'milk alkali syndrome' which is a syndrome characterized by the triad of hypercalcemia, alkalosis and renal insufficiency. This syndrome is most often precipitated by excessive ingestion of calcium carbonate preparations in predisposed individuals. In the acute presentation of this syndrome the patient develops symptoms within a week of the treatment. They have symptoms of hypercalcemia, including nausea, vomiting, weakness, and mental changes with psychosis or depressed sensorium. The also have severe metabolic alkalosis, a normal to elevated plasma phosphate concentration, and acute renal insufficiency. Withdrawal of milk and alkali leads to rapid relief of symptoms and the return of normal renal function.