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HARDASS Mnemonic for Normal Anion Gap Metabolic Acidosis

HARDASS Mnemonic/Acronym

HARDASS Mnemonic for Normal Anion Gap Metabolic Acidosis is one of the most popular and useful mnemonics to remember the causes of Normal Anion Gap Metabolic Acidosis. It can be a little difficult to remember the causes of Normal Anion Gap Metabolic Acidosis for your biology class or the MCAT. Now it’s easy with this HARDASS Mnemonic.

What does HARDASS stand for?

HHyperalimentation

Normal gap metabolic acidosis is caused on by hyperalimentation in the form of overeating and Total Parenteral Nutrition (TPN).

AAddison’s Disease

Addison’s disease, where there is a loss of aldosterone, leads to metabolic acidosis because of decreased activity of the the H+/ATPase pump in the intercalated cells of the collecting duct. As hydrogen is not secreted, due to a lack of aldosterone, H+ is retained inside the cells and consequently causes blood acidemia.

RRenal Tubular Acidosis

Another reason for Normal Anion Gap Metabolic Acidosis is renal tubular acidosis. Acid builds up in the body as a result of the kidneys’ inability to properly acidify the urine.

DDiarrhea

Due to an excessive loss of bicarbonate through the GI tract, diarrhea is a major cause of normal gap metabolic acidosis.

Acetazolamide

A Normal Anion Gap Metabolic Acidosis can result from the loss of bicarbonate in the urine caused by carbonic anhydrase inhibitors like Acetazolamide.

S Spironolactone

A Normal Anion Gap Metabolic Acidosis can be brought on by Spironolactone, which prevents aldosterone’s effects on the distal tubule. This is because a lack of aldosterone causes the sodium-hydrogen exchanger to waste sodium in the urine, leaving H+ in the serum.

S – Saline Infusion

Rapid infusion or sufficiently large doses of plasma expanders, such as normal saline, can sometimes lead to Normal Anion Gap Metabolic Acidosis.

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