Renal tubular acidosis Quiz: Ace Your Exams
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A 76-year-old woman presents to the emergency department with fatigue, decreased appetite, and muscle weakness. Past medical history includes chronic migraines, hypertension, gastroesophageal reflux, and a recent episode of podagra. Current medications include topiramate, lisinopril, acetazolamide, omeprazole, and probenecid. Temperature is 37.0°C (98.6°F), pulse is 104/min, respirations are 24/min, and blood pressure is 96/66 mmHg. Arterial blood gas and laboratory testing are obtained, and the results are shown below.
Which of the following medications most likely contributed to this patient’s disease?
| Laboratory value | Result | Reference range |
| Arterial blood gas | ||
| pH | 7.1 | 7.35-7.45 |
| pCO2 | 26 mmHg | 33-45 mmHg |
| pO2 | 84 mmHg | 75-105 mmHg |
| Blood, serum, plasma | ||
| Sodium | 134 mEq/L | 136-146 mEq/L |
| Chlorine | 110 mEq/L | 95-105 mEq/L |
| Potassium | 6.1 mEq/L | 3.5-5 mEq/L |
| Bicarbonate | 14 mEq/L | 22-28 mEq/L |
| Urine | ||
| pH | 5.0 | 4.6-8 |
Which of the following medications most likely contributed to this patient’s disease?
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