Which of the following is/are cause(s) of hyperchloremic ...

[Kikoku]

Which of the following is/are cause(s) of hyperchloremic metabolic acidosis? 1. Hyperalimentation 2. Methanol intoxication 3. Severe diarrhea 4. NH4Cl administration
 
  a. 2 only
  b. 1 and 4 only
  c. 1, 3, and 4 only
  d. 1, 2, 3, and 4

Question 2

What explains the lack of an increased anion gap seen in metabolic acidosis caused by HCO3 loss?
 
  a. For each HCO3 ion lost, a Cl ion is reab-sorbed by the kidney.
  b. For each HCO3 ion lost, the body pro-duces another to replace it.
  c. HCO3 is not a measured anion, so its loss does not affect the anion gap.
  d. Replacement of HCO3 occurs by ammo-nia ions which are also anions.

[Amiracle]

Answer to Question 1

ANS: B
Box 14-5 summarizes causes of anion gap and nonanion gap metabolic acidosis.

Answer to Question 2

ANS: A
A metabolic acidosis caused by HCO3 loss from the body does not cause an increased anion gap. Bicarbonate loss is accompanied by Cl ion gain, which keeps the anion gap within normal limits (Figure 14-7, C).

[Kikoku]

Excellent

[parshano]

TYSM