By Alluru S. Reddi
Written in a succinct query and resolution structure, this finished source covers all components of nephrology and customary medical eventualities. approximately one thousand questions with targeted solutions offer nephrology fellows, practising nephrologists and clinicians a greater knowing of nephrology and relief arrangements for nephrology and inner drugs forums. Absolute Nephrology overview positive factors the newest proof and instructions whereas pleasing a serious want in the nephrology community.
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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. Also, methanol intoxication is excluded based on normal osmolal gap.
Plasma K+lowering effect of albuterol is due to its transport into the cell. Hemodialysis is the most effective way of removing K+ from the body. Rapid removal of K+ may precipitate ventricular arrhythmias in some patients; therefore, continuous EKG monitoring is recommended. Peritoneal dialysis (PD) also removes K+ in maintenance PD patients with modest hyperkalemia; however, it is not the choice of treatment for severe hyperkalemia with EKG changes. It should be noted that glucose in the peritoneal fluid can transport K+ into the cell without affecting total body K+ stores.
215–231. 55. 0 mg/dL)? A. B. C. D. E. 0 mg/dL. Metabolic complications are clearly evident with severe hypophosphatemia. Muscle requires adequate amounts of ATP and creatine phosphate for its actions. Phosphate depletion leads to low intracellular phosphate and an increase in Na+, ClÀ, and water, resulting in myopathy, weakness, and muscle injury. Rhabdomyolysis is a complication of low serum phosphate, which may present with acute kidney injury. Metabolic acidosis due to severe hypophosphatemia is related to a decrease in net acid excretion (titratable acid and NH3), resulting in retention of H+.