NBME 20 Answers ↦
I found this to add a little bit more explanation as to how it causes the acidosis if anyone needs it.
1. Mitochondrial toxicity - decreases aerobic respiration and shunts to lactic acid production
2. Cardio toxicity (Secondary to Mitochondrial toxicity) leads to cardiogenic shock (hypoperfusion), which causes lactic acidosis
3. Hepatotoxicity - Decreases lactate metabolism, causing lactic acidosis
4. When in trivalent form (Fe+3), it can react with 3 molecules of H2O
--> FeOH3 + 3H+
This will then deplete Bicarb buffering system resulting in non-gap acidosis.
None of the other choices were even metabolic acidosis. They threw us a bone with this one.
Don't changes in bicarb take a few days? How did his bicarb drop down to 8 in 12 hours?
they did throw us a bone however I didnt catch it