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A 67-year-old male is brought to the ER because of increasing abdominal pain and nausea for the past few
hours. He has multiple medical problems including type-2 diabetes. hypertension. hyperlipidemia. coronary
artery disease. cerebrovascular accident, peripheral vascular disease. ischemic cardiomyopathy and atrial
fibrillation. He has not been on anticoagulation because of recurrent bleeding peptic ulcer disease. He has
had a cholecystectomy. He takes multiple medications at prescribed doses and lives at home with his
family. He quit smoking 10 years ago and does not use alcohol or drugs. His temperature is 37.8C (100.0F).
blood pressure is 150/90 mm Hg. pulse is 11 0/min and respirations are 22/min. Physical examination shows
an elderly male in acute distress. Lungs have few crackles at the bases. Heart rate is irregular. Bowel
sounds are decreased and diffuse tenderness is present. There is no peripheral edema. Initial laboratory
studies show the following:
Serum sodium 140 mEq/ L
C hloride 103 mEq/ L
Bicarbonate 14 mEq/L
Blood urea nitrogen (BUN) 20 mg/d l
Serum creatinine 0.8 mg/d l
Blood glucose 198 mg/d l
Amylase 255 U/ L

Which of the following is the most likely diagnosis in this patient?

r A. Diabetic ketoacidosis
r B. Bowel ischemia
r C. Acute pancreatitis
r D. Acute appendicitis
r E. Peptic ulcer perforation
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Item: 2 of 5
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A 56-year-old male with a history of type-2 diabetes presents for a routine office visit. His blood work from two
months ago showed hyperkalemia. and at that time his physician discontinued lisinopril. His repeat blood
work done today is shown below:
Chemistry panel
Serum sodium 136 mEq/L
Serum potassium 5.6 mEq/L
Chloride 110 mEq/L
Bicarbonate 18 mEq/L
Blood urea nitrogen (BUN) 26 mg/dl
Serum creatinine 1.9 mg/dl

He currently takes glipizide. furosemide. nifedipine and aspirin. His blood pressure is 150/90 mmHg.
Examination is unremarkable. Which of the following is the most likely cause of his low bicarbonate and
elevated potassium?

r A. Chronic renal failure

r B. Renal tubular acidosis
r C. Furosemide
r D. Glipizide
r E. Nifedipine
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Q.ld: 2804 ( Previous Ne><t Lab Values Notes Calculator

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A 32-year-old pregnant female is being evaluated at her 32nd week of gestation. Her lab profile shows the
following
Blood pH 7.44
Pa02 100 mmHg
PaC02 30 mmHg
HC03· 20 mEq/L
WBC count 9,000/cmm
Hb 11 mg/dl

Na• 134 mEq/L

K• 3.6 mEq/1
CI- 98 mEq/L
BUN 5 mg/dl
Creatinine 0.6 mg/dl

Which of the following can best explain her acid-base status?

r A.Anemia
r B. Pulmonary embolism
r C. Obesity
r D. Normal phenomenon of pregnancy
r E. Hyperemesis gravidarum
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Q.ld: 2784 ( Previous Ne><t Lab Values Notes Calculator

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A 65-year-old white female comes to the ER because of persistent vomiting and epigastric pain. She has
been suffering from left knee osteoarthritis for the past 6 years, and has been taking ibuprofen for the
past year. She also has a history of chronic obstructive pulmonary disease but is well controlled on her
current medications. She quit smoking a few years ago. Her laboratory results are given below.
ABG
pH 7.55
PC02 46 mm Hg

Chemistry panel
Serum sodium 132 mEq/L
Serum potassium 3.0 mEq/ L
C hloride 88 mEq/ L
Bicarbonate 38 mEq/ L
Serum creatinine 0.8 mg/d l

Which of the following would describe her primary acid-base status?

r A. Normal profile
r B. Metabolic acidosis
r C. Metabolic alkalosis
r D. Respiratory acidosis
r E. Respiratory alkalosis
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Q.ld: 4216 ( Previous Ne><t Lab Values Notes Calculator

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A 22-year-old female is hospitalized after a car accident. She sustained a hip fracture. fractures of several
ribs and a blunt abdominal injury that required a laparotomy. The laparotomy revealed a liver laceration and
extensive hemoperitoneum. In the early postoperative period. the patient is noted to have hyperactive deep
tendon reflexes. Which of the following electrolyte abnormalities may be responsible for this condition?

r A. Hypokalemia
r B. Hyperkalemia
r C. Hyponatremia
r D. Hypocalcemia
r E. Hypermagnesemia