usmle262005
Forum Junior
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A 45 year old hypertensive male comes with periorbital edema, fatigue, nausea and anorexia. On exam, he has a bruit in his abdominal region. His blood studies are suggestive of hypokalemia and normocytic normochromic anemia. His GFR is 40 ml/min. Which of the following is the expected acid base status of the patient?
A. Normal anion gap acidosis
B. Increased anion gap acidosis
C. Metabolic alkalosis
D. Respiratory acidosis
E. Respiratory alkalosis
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| frank100
Forum Guru
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between (a) and (B). but because he is on renal failure (GFR is very low) Iīd choose B.
normo-normo anemia: tells me he has beem on this for a long time.
a low GFR tells me the one hammered is the kidney, ond the poor one can handle it no more...
patients with renal failure tend to have a high anion gap metabolic acidosis with compensation. so thatīs why I chose B.
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| usmle262005
Forum Junior
Topics: 7
Posts: 18
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ansc
renal artey stenosis------->hypertension and mild to moderate renal failure in this case
because of stenosis there is hypereninemic excess leading to mineralocorticosteroid excess which in turn leads to hypokalemia and hypertension.,(increased ammonium and potassium excretion)
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| mazinger
Forum Guru
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Agree its C
in normal slang  aldosterone increases acid secretion in alpha intercalated cells of the distal nephron..
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original mazinger z
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| frank100
Forum Guru
Topics: 48
Posts: 586
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sorry
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