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Normal Anion Gap Metabolic Acidosis — RACP Adult Medicine MCQ

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ModerateNephrologyNormal Anion Gap Metabolic AcidosisRACP Adult Medicine

A 55-year-old man presents with acute confusion. ABG shows pH 7.35, PaCO₂ 22 mmHg, HCO₃ 12 mmol/L. Na 140, K 3.8, Cl 115 mmol/L. What is the acid-base disturbance?

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Correct answer: ENormal anion gap (hyperchloraemic) metabolic acidosis with respiratory compensation

AG = 140 − (115 + 12) = 13 (normal). NAGMA with appropriate respiratory compensation. Causes: RTA, diarrhoea, ureteric diversion, acetazolamide, IV normal saline excess.

Reference: eTG – 2025 – Nephrology