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Old 06-20-2011
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Kidney Diabetes, Hypertension, and Hyperkalemia case

A 62 year old woman with long standing history of diabetes and hypertension presents for evaluation of hyperkalemia. Her room arterial blood gas (ABG) and electrolytes are the following:

ph: 7.38/pCO2 34/PO2 89
Na 140 Cl 106 BUN 51
K: 5.9; CO2 : 20; Cr : 2.8

Which of the following is the underlying renal abnormality?

A. Renal tubular Acidosis, type 2
B. Focal segmental glomerulonephritis
C. Interstitial Nephritis
D. RTA, type 4
E. Barter Syndrome
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Old 06-20-2011
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D---RTA type 4
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Old 06-20-2011
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Quote:
Originally Posted by willshineIA View Post
D---RTA type 4
but there is respiratory alkalosis not metablic acidosis (RTA casue hyperklemia)

in barter must be normotensive
in Focal segmental glomerulonephritis (HIV - drug addict and young african not old)
in Renal tubular Acidosis, type 2 there is hypoklemia

iwill go with C . Interstitial Nephritis (answer)
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Old 06-21-2011
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Answer is D. RTA type IV is asscoiated with diabetes and hypertension , damage to the JGA in the glomeruli leads to renin production. This results in hypoaldosteronism, causing hyperkalemia and a non gap metabolic acidosis
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Old 06-21-2011
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from where these questions (source) can i ask ???????
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Old 06-21-2011
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Kaplan lecture notes internal medicine u ll find the answer p. 264 RTA type IV
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Endocrinology-, Nephrology-, Step-2-Questions

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