A 46-year-old man presents with 3 days of weakness and lightheadedness following broad-spectrum antibiotic initiation. He reports profuse watery diarrhea. Vital signs: BP 118/76 mmHg, HR 102/min, RR 20/min, temperature 37.2°C. Serum electrolytes reveal Na+ 138 mEq/L, Cl− 112 mEq/L, and HCO3− 16 mEq/L. Arterial pH is 7.28. Urine electrolytes are normal. Which acid-base disorder best explains these findings?
- A)Respiratory acidosis
- B)Respiratory alkalosis
- C)Nonanion gap metabolic acidosisGABARITO
- D)Metabolic alkalosis
- E)Anion gap metabolic acidosis
Explicação
Diarrhea causes loss of bicarbonate-rich intestinal fluid, producing a hyperchloremic nonanion gap metabolic acidosis. The chloride is elevated as bicarbonate falls, preserving electroneutrality without generating an increased anion gap. Ver explicação completa e trilha adaptativa →