BOF: 43
A 26-year-old male presents with a history of pain
radiating from his loin to his groin.
His investigations are as follows:
Sodium 138 mmol /L
Potassium 2.5 mmol /L
Bicarbonate 14.5 mmol/L
Chloride 114 mmol/L
Urinary pH 6.1
In this patient which one of the following would reduce the
incidence of complications of this condition?
a)
Loop diuretic
b)
Spironolactone
c)
Fludrocortisone
d)
Calcium
e)
Bicarbonate
Answer: e)
The patient’s history is suggestive of ureteric calculi.
The investigations show hypokalaemia, hyperchloraemia and the low bicarbonate
would suggest a metabolic acidosis. Hypokalaemia, hypochloraemic metabolic
acidosis in association with ureteric calculi would suggest that the patient has
type 1 renal tubular acidosis and treatment with bicarbonate would reduce
complications of this condition
Revision Tip
Revise renal tubular acidosis KEYS
to SUCCESS in Medicine page 336-340
