A 36-year-old woman presents with chronic watery diarrhea due to inflammatory bowel disease. She has pH 7.30 and serum bicarbonate 16 mEq/L. Her physician wants to distinguish extrarenal bicarbonate loss from renal tubular acidosis. Which of the following additional findings would be most consistent with diarrhea as the cause of her metabolic acidosis?
- A)Hyperkalemia due to low aldosterone
- B)Calcium phosphate kidney stones
- C)Negative urine anion gapGABARITO
- D)Positive urine anion gap
- E)Urine pH persistently above 5.5
Explicação
In diarrhea, the kidneys respond appropriately by increasing ammonium excretion, and this makes the urine anion gap negative. A negative urine anion gap therefore supports an extrarenal source of nonanion gap metabolic acidosis rather than a renal tubular acid... Ver explicação completa e trilha adaptativa →