Renal tubular acidosis Quiz: Ace Your Exams
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A 35-year-old woman presents to the emergency department with 3 days of difficulty urinating, right flank pain, malaise, and nausea. Medical history includes chronic migraines for the last 10 years, for which she has been taking ibuprofen multiple times daily. Temperature is 37.0°C (98.6°F), pulse is 90/min, respirations are 22/min, and blood pressure is 112/68 mmHg. Laboratory testing is obtained and the results are shown below.
Which of the following is the most likely cause of this patient’s symptoms?
| Laboratory value | Result | Reference range |
| Arterial blood gas | ||
| pH | 7.2 | 7.35-7.45 |
| pCO2 | 28 mmHg | 33-45 mmHg |
| pO2 | 80 mmHg | 75-105 mmHg |
| Blood, serum, plasma | ||
| Sodium | 138 mEq/L | 136-146 mEq/L |
| Chlorine | 119 mEq/L | 95-105 mEq/L |
| Potassium | 3.1 mEq/L | 3.5-5 mEq/L |
| Bicarbonate | 14 mEq/L | 22-28 mEq/L |
| Urine | ||
| pH | 8.1 | 4.6-8 |
Which of the following is the most likely cause of this patient’s symptoms?
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