Audio Qbank – HY USMLE Q #443 – Difficult acid-base

A 29-year-old woman is brought to the physician by her partner for increasing lethargy and ear-ringing over the past 24 hours. She has history of rheumatoid arthritis for which she takes aspirin, ibuprofen, acetaminophen, and steroids to manage the pain. Which of the following combinations of serum electrolytes (in mEq/L) and pH is most likely to be seen in this patient?

↓ Na+; ↓ K+; ↓ Cl; ↔ HCO3; ↔ pH; ↔ anion gap
↓ Na+; K+; ↔ Cl; ↓ HCO3; ↓ pH; ↔ anion gap
↓ Na+; ↔ K+; ↓ Cl; ↓ HCO3; ↔ pH; ↑ anion gap
↔ Na+; ↑ K+; ↑ Cl; ↓ HCO3; ↓ pH; ↑ anion gap
↑ Na+; ↔ K+; ↑ Cl; ↔ HCO3; ↔ pH; ↔ anion gap