drpatinoireIf she has Crohn, she has already lost a lot of K, HCO3-, then the compensatory system wouldn't let her keep losing electrolytes in her urine. +2019-12-15T12:12:22Z
krewfoo99Why would the urine Potassium be so high if it is type 1 ? Shouldnt it be type 2?+2019-11-03T05:18:31Z
drpatinoire@krewfoo99 I think it's RTA2 (Fanconi syndrome), he is losing all kinds of Na, K, Cl which should be reabsorbed in PCT. +2019-12-15T12:08:26Z
subclaviansteeleMy take is that hes not super acidotic and the K is at the low end.+2019-07-01T16:41:37Z
nwinkelmannsee the comment by @zbird, which explains that the urine anion gap is important (which I took to interpret as more important than the serum K+ level, lol, because the normal K threw me off too).+2019-07-12T23:43:59Z
mousieAnion Gap: Na - (Cl + HCO3) = normally around 10-12 +12019-06-03T10:39:47Z
seagullgood to know. I keep looking up the urine values but all it said was "varies", then I threw my computer and yelled "does that vary Mother F****ers. I do feel better now. +282019-06-07T23:26:31Z
_yeetmasterflexglad I wasn't the only one who got very pissed off at the urine values+42019-06-10T05:12:24Z
fulminant_lifeUsually the first thing I look at is whether or not the Cl- is high. Generally if the Cl- is high its going to be a normal gap+22019-06-23T17:19:26Z
henoch schonleini think they gave you the urine values bc you can calculate the URINE anion gap which is (Na + K - Cl). In this case the Urine Anion Gap is positive (5). Boards and Beyond mentions that a positive UAG is due to Renal Tubular Acidosis Type 1 (inability of alpha intercalated cells to secrete hydrogen ions). just another approach to answer this q+122019-06-26T16:36:13Z
270onstep1Actually diarrhea is the "D" in "HARDASS"(reason why I was stuck between Chron's and RTA). Ended up getting it right with RTA..+12019-09-12T16:32:42Z
talha_sSo the reason this is not Crohn's disease is actually what BnB explains in Renal Tubular acidosis video. Anytime there is a Metabolic Acidosis with intact kidney secretion of H+, the URINARY Anion gap (Na+K-Cl) is NEGATIVE. This is because the excess NH4 that is secreted into urine is combined with Cl-. Therefore, in Crohn's disease and Type 2 Renal Tubular Acidosis, the urinary anion gap is NEGATIVE.
In this question, the urinary anion gap is POSITIVE so this would be an example of Type 1 RTA because the kidney can not excrete H+.
I got it right by chance, definitely did not understand it in this much detail when I was answering it lol+12020-02-07T15:25:41Z
daddyyikesother than the patient not haveing any sxs of crohn's i dont see any reason why its not crohn's. we differ crohn's and rta by urine anion gap. in chronic diarrhoea it is negative while in rta its +ve but in question the anion gap was normal+2019-08-09T07:14:43Z