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Author3 Posts
  #1

This Q is from USMLE easy. Can somebody please explain me how to approach this Q? Their explanation wasn't good enough for me.

A patient with diabetic ketoacidosis along with a bout of viral gastroenteritis resulting in diarrhea has which of the following patterns? Sodium Chloride Bicarbonate pCO2 pH
A 140 109 12 26 7.29
B 140 115 15 30 7.30
C 140 103 15 25 7.34
D 140 102 25 58 7.26

  #2

Should be A. DKA gives an increased AG acidosis, and diarrhea causes loos of base in stool. Therefore I think you should pick the lowest pH. C could also be correct, since Cl- is lower, but the pH is too close to normal. Since this case is two sets of metablic acidosis, you should start with the lowest pH/lowest bicarbonate and rule out options from there.

  #3

Thanks! htst makes a lot of sense; actually while attempting it, I was thinking of vomiting from GI (careless reading) so I was thinking more met alkalosis....very confused; but it makes perfect sense now, thaks again.









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