NBME Step 2 CK Form 6 Na+: 140;<br />Cl-: 80;<br />K+: 2.5;<br />HCO3-: 40 (NBME Answers)

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Retired NBME Step 2 CK Form 6 Answers

step2ck_form6/Block 2/Question#18 (reveal difficulty score)
A 35-year-old man is brought to the emergency ...
Na+: 140;
Cl-: 80;
K+: 2.5;
HCO3-: 40 🔍 / 📺 / 🌳 / 📖
tags: renal

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submitted by ∗medicalmike(82)

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Intractable vomiting results in hypochloremic metabolic alkalosis due to loss of HCl. (B) is the only choice with elevated HCO3-. K+ is low due to elevated aldosterone activity from contraction alkalosis.

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tinylilron Is sodium not affected (140) because aldosterone is able to compensate? For some reason, I thought that one could lose sodium with intractable vomiting too? +

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submitted by ∗kingfriday(45)

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This one got me :( i had the right answer but i switched because i kept getting hung up on his PPI treatment (rereading the stem now, it seems he's off treatment)

but can someone explain to me what the answer would be if the guy were on a PPI and had intractible vomiting?

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ddub H2-rec blocking agent is not a PPI +3

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