Audio Qbank – Q262 – A 3M with a fracture

 

A 3-year-old boy is brought to hospital because of severe pain and distortion of his right arm. His sclerae show no abnormalities. An x-ray of the patient’s humerus is shown.

The deficient enzyme responsible for this patient’s condition bears isoforms that can be inhibited by a diuretic. Which of the following combinations of urinary findings are expected in a patient who commences this diuretic?

↑ HCO3; ↑ pH; ↑ osmolality
↑ HCO3; ↑ pH; ↓ osmolality
↑ HCO3; ↓ pH; ↑ osmolality
↑ HCO3; ↓ pH; ↓ osmolality
↓ HCO3; ↑ pH; ↑ osmolality
↓ HCO3; ↑ pH; ↓ osmolality
↓ HCO3; ↓ pH; ↑ osmolality
↓ HCO3; ↓ pH; ↓ osmolality