A 51-year-old woman is evaluated in hospital. She takes a daily multivitamin. Her mom had a history of osteoporosis. Vitals are normal. Serum studies are shown.
Chloride 104 mEq/L
Bicarbonate 20 mEq/L
Sodium 135 mEq/L
Which of the following is the most likely explanation for this patient’s findings?
A) Aspirin toxicity
B) Diabetic ketoacidosis
C) Lactic acidosis
D) Renal insufficiency
E) Renal tubular acidosis

