share email twitter ⋅ join discord whatsapp(2ck)
free120  nbme24  nbme23  nbme22  nbme21  nbme20  nbme19  nbme18  nbme17  nbme16  nbme15  nbme13 

NBME 22 Answers

nbme22/Block 3/Question#29 (45.4 difficulty score)
A 45-year-old man with end-stage renal ...
BicarbonateπŸ”
tags:

Login to comment/vote.


 +10 
submitted by skraniotis(10),
unscramble the site ⋅ remove ads ⋅ become a member ($39/month)

idUzeadlny aerln efuaril lasde ot toiabmlec ,cdoiasis dan sa a slretu rbiabc estg pedetled as ti serit to eurbff eht ualtouimncac of ranigco s.acid

bubbles  Thanks for the explanation! Do you know why Mg would not be a potential answer? Phosphate also accumulates in those with undialyzed renal failure, so I was thinking that maybe magnesium as a divalent cation would complex with PO3 (in a mechanism similar to Ca). +  
nwinkelmann  From the little bit of research I just did (because I didn't learn anything about dialysis at my medical school), ESRD can be associated with either low or high Mg levels, so the dialysate can cause either increased or decreased Mg levels depending on the patient's serum content, therefore I don't think based on this question, would could determine if removal of dialysis would lead to elevated or decreased magnesium. The end of the first article seems to favor ESRD leading to hypermagnesemia, so if that's the case, then removal of dialysis would cause Mg to increase as well. https://www.karger.com/Article/FullText/452725 and https://www.karger.com/Article/FullText/485212 +1  
hyperfukus  why is it that we aren't learning this stuff and they r just throwing it on step there's barely a blurb in FA about ckd/eskd +1  
hyperfukus  does uremia potentially have to do with this? +  
medulla  ESRD and not getting dialysis -> he is uremic -> met acidosis -> dec bic +11  
angelaq11  @medulla this is the best and simplest explanation. I got it wrong and chose Mg, wish I had made that connection. +  



 +5 
submitted by medulla(27),
unscramble the site ⋅ remove ads ⋅ become a member ($39/month)

Rlean Faelu:ri DMA RHGENU M et iiAcdsso Dlasdy mepiii lmmeiyeU ka riraaHep ci(n UBN ect) raaewtN / nrtoteeni H,F( uylmoanpr edame, HTN) wrGh to tetriaaodnr adn vtneamedlelop ylead tyhonorEei ript aulrife e)i(mana e Rnla syhoopsyodtret