Acid–Base Disorders

Intermediate MCQs for Nephrologists

Assess your clinical reasoning in primary and mixed acid–base disorders, compensation, anion-gap interpretation, and renal tubular acidosis.

Acid–Base Disorders — Intermediate

Difficulty: Intermediate

Test your clinical reasoning in primary and mixed acid–base disorders, compensation, anion-gap interpretation, and renal tubular acidosis. This quiz contains 10 single-best-answer questions. Explanations are shown after quiz completion.

1 / 10

A 54-year-old patient has a serum bicarbonate of 16 mmol/L, chloride 116 mmol/L, and sodium 140 mmol/L after several days of profuse diarrhea. Which acid–base disorder best explains these findings?

High-anion-gap metabolic acidosis

Normal-anion-gap metabolic acidosis

Metabolic alkalosis

Respiratory acidosis

2 / 10

A patient with metabolic acidosis has a serum bicarbonate concentration of 12 mmol/L. Using Winter’s formula, which arterial PCO2 is most consistent with appropriate respiratory compensation?

12 mmHg

26 mmHg

40 mmHg

52 mmHg

3 / 10

A patient has sodium 140 mmol/L, chloride 100 mmol/L, and bicarbonate 10 mmol/L. Albumin is normal. What is the calculated serum anion gap?

10 mmol/L

20 mmol/L

30 mmol/L

50 mmol/L

4 / 10

A patient with diabetic ketoacidosis has bicarbonate 10 mmol/L and PCO2 35 mmHg. What additional acid–base process is present?

Concurrent respiratory alkalosis

Concurrent respiratory acidosis

Concurrent metabolic alkalosis only

No additional process

5 / 10

Which finding most strongly supports distal (type 1) renal tubular acidosis?

Urine pH below 5.0 during systemic acidosis

Persistent urine pH above 5.5 during systemic acidosis

Hyperkalemia with low renin

Marked glucosuria with normal serum glucose

6 / 10

A patient with diabetic kidney disease has normal-anion-gap metabolic acidosis and persistent hyperkalemia. Which mechanism is most likely?

Excessive distal hydrogen secretion

Reduced aldosterone activity or resistance

Increased ammonium excretion

Primary respiratory alkalosis

7 / 10

A patient with vomiting has metabolic alkalosis, low urine chloride, and evidence of volume depletion. Which treatment is most appropriate initially?

Intravenous isotonic saline

Intravenous sodium bicarbonate

Acetazolamide as sole therapy

Immediate hemodialysis

8 / 10

In chronic respiratory acidosis, by approximately how much does serum bicarbonate increase for each 10-mmHg increase in PCO2 above 40 mmHg?

1 mmol/L

2 mmol/L

3.5–4 mmol/L

10 mmol/L

9 / 10

A patient with tinnitus and tachypnea has a high-anion-gap metabolic acidosis and a low PCO2. Which exposure most likely produces this mixed disorder?

Opioids

Salicylates

Thiazide diuretics

Pure methanol exposure

10 / 10

A patient has sodium 138 mmol/L, chloride 100 mmol/L, bicarbonate 12 mmol/L, and albumin 2 g/dL. What is the best interpretation after albumin correction?

The anion gap is normal and no additional process is present

The measured gap is 26 mmol/L and is substantially elevated after correction

The patient has isolated metabolic alkalosis

Albumin has no meaningful effect on the anion gap

Your score is

The average score is 70%

By Wordpress Quiz plugin

Acid–Base Disorders

Services

Follow Us