By Alluru S. Reddi
Written in a succinct query and resolution layout, this finished source covers all parts of nephrology and customary scientific eventualities. approximately a thousand questions with distinctive solutions offer nephrology fellows, practising nephrologists and clinicians a greater realizing of nephrology and reduction arrangements for nephrology and inner medication forums. Absolute Nephrology evaluate positive factors the most recent proof and guidance whereas pleasant a severe desire in the nephrology community.
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It should be noted that glucose in the peritoneal fluid can transport K+ into the cell without affecting total body K+ stores. Thus, option E is incorrect. Suggested Reading Reddi AS. Disorders of potassium: Hyperkalemia. In Reddi AS. Fluid, Electrolyte, and Acid-Base Disorders. Clinical Evaluation and Management. New York, Springer, 2014, pp. 177–191. 46. A 22-year-old female student presents to her student health clinic for fatigue and weakness of her lower extremities following her routine jogging.
Serum creatinine is normal. The anion gap is 20, but osmolal gap is normal. Which one of the following is the MOST likely cause of this acid–base disturbance in this patient? A. L-Lactic acid B. Pyroglutamic acid 1 Fluids, Electrolytes, and Acid–Base Disorders 39 C. D-Lactic acid D. Methanol E. Topiramate The answer is C Except for topiramate, all other causes generate high AG metabolic acidosis. Topiramate causes non-AG metabolic acidosis due to inhibition of carbonic anhydrase. Serum L-lactate is normal; therefore, L-lactic acidosis is excluded.
Evaluation of an acid-base disorder. In Reddi AS. Fluid, Electrolyte, and Acid-Base Disorders. Clinical Evaluation and Management. New York, Springer, 2014, pp. 301–317. 57. A 72-year-old woman with a history of type 2 diabetes mellitus, congestive heart failure (CHF), and renal failure is admitted for nausea, vomiting, and shortness of breath. Her medications include insulin and furosemide. Her weight is 60 kg. 40 pCO2 ¼ 40 mmHg pO2 ¼ 90 mmHg HCO3À ¼ 24 mEq/L Which one of the following acid–base disturbances is CORRECT?