nbme20/Block 4/Question#31
A 48-year-old man is brought to the emergency ...
Cl-: 96 mEq/L; HCO3-: 8 mEq/L
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: https://forums.studentdoctor.net/threads/iron-poisoning-anion-gap-or-non-anion-gap-acidosis.958285/
+2 2019-05-28T04:04:50Z
sympathetikey
None of the other choices were even metabolic acidosis. They threw us a bone with this one.
+ 2019-05-31T23:40:14Z
submitted by hayayah(217), 2019-05-16T15:53:45Z
Iron overdose is a cause of a high anion gap metabolic acidosis.