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Category: Critical Care Medicine-Renal, Electrolyte and Acid Base Disorders--->Potassium
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Question 1#Print Question

A 78-year-old lady was found at her home after a fall earlier in the day by her daughter. Medication history is significant for aspirin, statin, glipizide, and acetaminophen use for chronic low back pain. She recently visited her primary care physician with significant weight loss and failure to thrive. She is currently admitted in the intensive care unit (ICU) for multiple rib fractures and flail chest. Her urine analysis and labs are as follows:

What is the most likely cause for her acid-base abnormality and hyperkalemia?

a. Ketones from starvation ketosis
b. 5-Oxoproline
c. Isopropyl alcohol
d. Lactic acidosis


Question 2#Print Question

A 55-year-old male with a long-standing diabetes, heart failure with reduced ejection fraction, and open-angle glaucoma presents to the emergency room. He reports loose stools for last few days. His list of medications includes metoprolol, acetazolamide, atorvastatin, aspirin, and metformin.

Serum:

  • pH—7.30
  • pCO2—40 mm Hg
  • Na—145 mEq/L
  • K—3.0 mEq/L
  • HCO3—10 mEq/L
  • Cl—125 mEq/L
  • Albumin—4 g/dL

Urine:

  • Na—56 mEq/L
  • K—10 mEq/L
  • Cl—76 mEq/L

The most likely cause of this patient’s acidosis is:

a. Diarrhea
b. Renal tubular acidosis
c. Spironolactone use
d. Acetazolamide use


Question 3#Print Question

A 59-year-old female with a history of hypertension and gout is admitted in the ICU for observation status post thrombolysis for ischemic stroke. Her outpatient medications include metoprolol, colchicine, aspirin, metformin, and meloxicam. Vitals are normal except for sinus tachycardia with a heart rate (HR) of 108 beats per minute. Low bicarbonate is noted on labs prompting an arterial blood gas (ABG), and patient is found to be mildly acidotic. Lab values are given below:

Urine electrolytes:

  • Na—56 mEq/L
  • K—10 mEq/L
  • Cl—56 mEq/L

Which of the following can most likely be expected to be the cause of this?

a. Chronic diarrhea
b. Type 1 renal tubular acidosis
c. Type 4 renal tubular acidosis
d. Bartter syndrome


Question 4#Print Question

A 55-year-old female presents with headaches and generalized weakness. Her mental status is intact. Her vital signs are blood pressure (BP) 170/80 mm Hg, HR 120/min, respiratory rate (RR) 18/min, and temperature 36.8°C.

Lab values:

What is the next best test to determine the cause of this acid-base abnormality?

a. Serum cortisol
b. Urine electrolytes
c. Serum ionized calcium
d. Liver function test


Question 5#Print Question

A 30-year-old male with history of alcohol abuse presents with nausea and vomiting. He is jaundiced, agitated, and endorsing visual hallucinations. Vital signs are as follows:

  • BP 105/100 mm Hg
  • RR 22/min
  • HR 110/min
  • Temperature 38°C

Labs and ABG values are shown below:

Which of the following best describes the acid-base disorder?

a. Metabolic acidosis/respiratory alkalosis
b. Respiratory alkalosis
c. Combined respiratory alkalosis, metabolic acidosis, and metabolic alkalosis
d. Metabolic alkalosis and respiratory alkalosis




Category: Critical Care Medicine-Renal, Electrolyte and Acid Base Disorders--->Potassium
Page: 1 of 1