A 40-year-old woman presents with severe metabolic acidosis (pH 7.22, bicarbonate 12 mmol/L) and a normal anion gap of 12 mmol/L. Serum potassium is

Question

A 40-year-old woman presents with severe metabolic acidosis (pH 7.22, bicarbonate 12 mmol/L) and a normal anion gap of 12 mmol/L. Serum potassium is 2.6 mmol/L. Urine pH is 7.0 (inappropriately alkaline). Urine anion gap is positive. What is the most likely diagnosis?

Accepted Answer

Distal renal tubular acidosis (Type 1 RTA)

Answer

Type 4 RTA (hypoaldosteronism) as the diagnosis

Answer

Proximal renal tubular acidosis (Type 2 RTA)

Answer

Diarrhoea-related bicarbonate loss as the unifying diagnosis

Answer

Acetazolamide use as the unifying clinical diagnosis

Type 1 RTA — ESENeph MCQ

A 40-year-old woman presents with severe metabolic acidosis (pH 7.22, bicarbonate 12 mmol/L) and a normal anion gap of 12 mmol/L. Serum potassium is 2.6 mmol/L. Urine pH is 7.0 (inappropriately alkaline). Urine anion gap is positive. What is the most likely diagnosis?