A 61-year-old male is given acetazolamide to treat open-angle glaucoma. Upon diuresis, his urine is found to be highly alkaline. Which of the following accounts for the alkaline nature of this patient’s urine?
AInhibition of bicarbonate reabsorption in the proximal tubule
BInhibition of bicarbonate reabsorption in beta-intercalated cells
CInhibition of acid secretion in alpha-intercalated cells
DInhibition of chloride reabsorption in the distal convoluted tubule
EInhibition of chloride reabsorption in the thick ascending loop of Henle
A 67-year-old man presents to his primary care physician because of weak urine stream, and increasing difficulty in initiating and stopping urination. He also reports of mild generalized body aches and weakness during the day. The past medical history includes diabetes mellitus type 2 for 35 years and essential hypertension for 19 years. The medication list includes metformin, vildagliptin, and enalapril. The vital signs include: temperature 36.7°C (98.1°F), blood pressure 151/82 mm Hg, and pulse 88/min. The physical examination is remarkable for markedly enlarged, firm prostate without nodules. The laboratory test results are as follows: Serum sodium 142 mEq/L Serum potassium 5.7 mEq/L Serum chloride 115 mEq/L Serum bicarbonate 17 mEq/L Serum creatinine 0.9 mg/dL Arterial pH 7.31 Urine pH 5.3 Urine sodium 59 mEq/L Urine potassium 6.2 mEq/L Urine chloride 65 mEq/L Which of the following most likely explains the patient’s findings?
AFanconi syndrome
BType 1 renal tubular acidosis
CType 2 renal tubular acidosis
DType 4 renal tubular acidosis
EEnd-stage renal disease
A 72-year-old female is brought to the emergency department after being found unresponsive in her garage with an open bottle of unmarked fluid. She is confused and is unable to answer questions on arrival. Her medical history is significant for Alzheimer disease, but her family says she has no medical comorbidities. Serum analysis of this patient's blood shows a pH of 7.28 with a high anion gap. The electrolyte that is most likely significantly decreased in this patient follows which of the following concentration curves across the proximal tubule of the kidney?
ACurve C
BCurve E
CCurve B
DCurve A
ECurve D
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