share email twitter ⋅ join discord whatsapp(2ck)
Free 120  NBME 24  NBME 23  NBME 22  NBME 21  NBME 20  NBME 19  NBME 18  NBME 17  NBME 16  NBME 15  NBME 13 
search for anything NEW!
NBME 20 Answers

nbme20/Block 4/Question#31 (44.9 difficulty score)
A 48-year-old man is brought to the emergency ...
Cl-: 96 mEq/L; HCO3-: 8 mEq/LπŸ”,πŸ“Ί

Login to comment/vote.

Tutor box

Members from the Leaderboard offering 1-on-1 help: Want to be listed here? Email us!

submitted by hayayah(1100),
unscramble the site ⋅ remove ads ⋅ become a member ($39/month)

rnIo odrosvee is a eaucs of a ihhg nnaoi gap itlaombce csao.isdi

meningitis  I found this to add a little bit more explanation as to how it causes the acidosis if anyone needs it. 1. Mitochondrial toxicity - decreases aerobic respiration and shunts to lactic acid production 2. Cardio toxicity (Secondary to Mitochondrial toxicity) leads to cardiogenic shock (hypoperfusion), which causes lactic acidosis 3. Hepatotoxicity - Decreases lactate metabolism, causing lactic acidosis 4. When in trivalent form (Fe+3), it can react with 3 molecules of H2O --> FeOH3 + 3H+ This will then deplete Bicarb buffering system resulting in non-gap acidosis. Source: +18  
sympathetikey  None of the other choices were even metabolic acidosis. They threw us a bone with this one. +31  
imnotarobotbut  Don't changes in bicarb take a few days? How did his bicarb drop down to 8 in 12 hours? +2  
charcot_bouchard  its met acidsis. not compensation +9  
j44n  they did throw us a bone however I didnt catch it +4  

submitted by markmizrachi(0),

High anion gap metabolic acidosis due to Iron excess (the I in MUDPILES). Serum anion gap = (Na) - [(HCO3 + Cl)]. Chloride levels low;HCO3 low, which results in the high anion gap.