NBME 20 Cl<sup>-</sup>: 96 mEq/L; HCO3<sup>-</sup>: 8 mEq/L (NBME Answers)

need help with your account or subscription? click here to email us (or see the contact page)

search for anything ⋅ score predictor (“predict me!”)

NBME 20 Answers

nbme20/Block 4/Question#31 (reveal difficulty score)
A 48-year-old man is brought to the emergency ...
Cl^-: 96 mEq/L; HCO3^-: 8 mEq/L 🔍 / 📺 / 🌳 / 📖
tags:

+6 upvote downvote
submitted by ∗hayayah(1212)

get full access to all content ⋅ pick a username

Iron overdose is a cause of a high anion gap metabolic acidosis.

get full access to all content ⋅ pick a username

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/ +20

sympathetikey None of the other choices were even metabolic acidosis. They threw us a bone with this one. +33

imnotarobotbut Don't changes in bicarb take a few days? How did his bicarb drop down to 8 in 12 hours? +2

charcot_bouchard its met acidsis. not compensation +9

j44n they did throw us a bone however I didnt catch it +7

+0 upvote downvote
submitted by manarashour(1)

get full access to all content ⋅ pick a username

regarding my understanding, we are looking for option with high anion gap metabolic acidosis so you will exclude choice A and D because HCO3 high in them, then you will consider Na 140 as they mention in the question it is normal so if you add the cl to HCO3 in option C you will get 134 so it will be normal anion gap so only choice you left with is B.

get full access to all content ⋅ pick a username

Must-See Comments from nbme20

amorah on Cytomegalovirus infection
masonkingcobra on Contact with parakeets
hayayah on Capillary hydrostatic: increased; ...
hayayah on X chromosome-linked isoenzymes
medbitch94 on Mannose 6-phosphate
hello on Capillary hydrostatic: increased; ...
hayayah on Osteoblasts
imgdoc on Hypophosphatemia
hayayah on Missense
celeste on 50%
justgettinby on Omeprazole
andrewk1 on Cold, dry air
yotsubato on Jugular venous pressure of 12 mm Hg
strugglebus on Drug effect