FORMULAE COMPILED PSM

INTEGRATED MODULE

Q. 500 people were monitored in a cohort study out of which 400

Q. 500 people were monitored in a cohort study out of which 400 were smokers. 50 of these developed lung cancer while 5 non-
were smokers. 50 of these developed lung cancer while 5 non- smokers developed lung cancer. If smoking was eliminated from
-

smokers developed lung cancer. What is the RR? the community, what proportion of lung cancer cases I would
decrease? calculate PAR

Attributable Zan*
Yo

mathisn=
=

A. 1.2 A. 60%
(Exidence)exposed Risk
[Incidence)Non - Exposed
B. 12.5 B. 55%
-

v
C. 2.5 C. 50% I
PAR
- >
=>
-

10
x
/ 2.5 100 100

5
RR I 50 -> x
=
x

D. 5 -

↑00 5 D. 40% - -
-

- 55
-
"100
T 500

4x100
=>
55%
=
 Disease
Epidemiology I -

Q. A screening test is positive in 50% diseased population and

-
-
RF
ad 10% healthy population. Calculate the PPV
Odds ratio/ Cross product:
6 Case control Se

I last
Relative risk/ Risk ratio : Esed 100
*
A. 83 PPV
50 X
(lung)
=
I won Exposed diseased -

proportion of
3
(50 10)
+

Risk factor
( XN
I Exposed INE
Attributable risk/ Absolute risk:
-

attributable dit B. 90
<Smoking)
-

IE
-> 50 x LON
C. 50
Factor (sundling it 5
I eliminating
Population attributable risk: I Total INE the Risk
-

-
x100
D. 89
disease (calung)
I
cohort studies total ↓

Screening BIOSTATISTICS
Disease - probability of committing an x eraor
ALPHA ERROR / p value: Statiscally significant study ->
↑ (0.05
+ - ⑦ -

Confidence level : 1-p >95%

a
PPV I

↑
sample (n), & Sn
+ a ( - P) b (FP)
-

a b
+
Power of study: ↓ -

B 3- Power of study 4:↓

B errors,
size
Test

-
C (FN) d (TN) NPV - d
--

d 2
+
-
⑪ rmsi] a
study
↓ data

variation
multiple multiple sets to measure
an" ]
.
data -

=d
Coefficient of variation -
studies of dat a
Sp
A
xN +d
Sn =
prevalence =
-
2

d b
+
Variance (SD)
=

25E] population
95%
SD
Standard error of mean: mean
=
I
Confidence interval
-

(population)
Youden index: (n sp 2) 5
+ -

Bayes theorem:
Sn x X
prevalance lub spx 1 - prevalence)
Standard error of proportion:
I- p prevalance
=

PPV =

Nov
=

-> --

(2 3n) (prevalence)
q 1
=

P
(- sp)(1 prevalence)
-

(Snxprevalence) +
spx(1-prevalance) + Sample size ↑ Pa
- -

d
d Absolute
=

/allowable error
 Q. What will be the 95% confidence interval (CI) for an estimated
prevalence of 10% and a sample size of 100?
-

SD 10 1 50.5 a. 2–18
SEmean
=
- =
=

- - -
- -
b. 4–16
In 140 20
c. 7–13
d. Given data inadequate for calculation of class intervals

confidence: mean 2
I SE -

-a
↓ (x
3
=

interval
= =

SE
25I2(0.5)
=>
proportion 100

=> 10% I (2x3)

I 1 2I
=

25

Q. A study was conducted in a population with prevalence of QIn a study to evaluate anti-hypertensives, it was found that
10%. The relative precision is 20%, alpha error is 5% and power is diuretics decrease the diastolic blood pressure by 20% with a p-
-

20%. Calculate sample size: value of < 0.1. What does this p-value imply? -
-

-
-

↳
significant 20'. error
->
4pq -
* 10 x 90
x Study - Not
I
size -
sample
=

-
↑
we have 90% confidence
d2
- A. The test is 90% reproducible ok
A. 900 X prevalance
thatthis
study is

Absolute error = ERelative 3 B. 90% of the patients will have greater than 20% reduction in blood pressure
precision
B. 3600 -
-
C. It can be said with 90% confidence that the result, i.e. 20% reduction in blood
=> 20 10 > 2
=

x
-

IO pressure is true and not by chance

C. 400
D. It can be said with 10% confidence that the result, i.e. 20% reduction in blood
pressure is true and not by chance
D. 600
BIOSTATISTICS
Mode= 3median – 2mean
Probability:
Mutually exclusive: -a
Independent factors: ->
Q. A study was conducted to assess the effectiveness of a new
Bimodal distribution treatment for a particular disease. In the control population,
3 there were 36 deaths/treatment failures out of sample of 120.
With the new treatment, 26 treatment failure were reported from
Blgroup I Probablye -I
By Addition
a sample size of 130. How many patients should be treated to
Data -

exanivele #
> Not
multiplication probability - of having
TB avert a single death?
CER 36
= -> B
p
& Blood
grp
A
orB
together 10
Odds: p probability 120
=

1 -

b
A. 100
Degree of freedom: Chi square => (Row-2) (column-2)
EER=
&*To
3
ARR: CER -
EER ·experimental drug
- EER
event Kate
B. 10
CER -
·control
drug
->
(incidence) ARR -

10
C. 250
RRR: CER-EER

-
--

EER
D. 160 NNT =
1
NNT: - ARR
ARR

Q. Graph of vitamin D value post ANC supplementation. Which Health and disease
option is wrong?
-25'1. Prevalence: Easesx Ino; proportion
25. 25%
↓ population
25% Total ·cross sectional study

median cb in
Patrist"100;Rate:
Incidence:
- di
skewed
.......

e
Positively Attack rate: new extent of epidemic don't
susceptiblescinate
cases

L
......... -
x
1000;
population risk
at
......

(PR)
one in incubatimpdx 100
Secondary attack rate (SAR): secondary
-
cases & iocase
25'
susceptibles in contact
- of values are >36 mg ④

3
A. 75%
- disease
Proportional mortality rate:
amdt
cause a x
100 Burden of
B. Positively skewed proportin
Total deaths

deaths dit a cause

Case fatality rate: a rirulence
C. Interquartile value 12–36 mg · of ds.

Total cases
D. Median at 24 mg
 Q. In a family of 4 children who were all unvaccinated, a child Demography mid year
population -> 1st
july
developed measles on 4th Aug 2023. 2 other children developed
Crude birth rate Births 1000;
x 16.9
measles by 15th Aug 2023. 5 other children in the neighbourhood Myp
developed measles on 1st September. Calculate the SAR Crude death rate Total
deaths/myp x 100; 9.2
Rule 70
of Popul" doubles
Annual growth rate: CBR
-
-
CDR
census
·
11 - 1.64% It If it is 2%,
children- IP 10
in
2 X LD 2 one t0 years
SAR I

A. 50% got infection

-

3 ->

susceptibles -> doesn'tinclud

B. 33% the i case
Total fertility rate (TFR) : Best for completed family size; TFR = 2.1

The sum of the ASFR for all reproductive age groups for a particular period
C. 66% couple protection
rate -> >60%
Gross Reproduction Rate (GRR):
D. 75% Sum of the ASFR (births of daughters), for all reproductive age groups for a particular period
-

Net reproduction rate (NRR): Best NRR 2 =

Average number of daughters that would be borne, according to specified rates of mortality and ASFR,
-

by a new-born female
-

Alterates 100,
/ India-7Pj cense e
Literacy rate -

Q. In a community, there are 2500 live births in the last one year.

S
Sex ratio 8 x 1800;943 During the same period, there are 5 deaths due to PPH, 3 due to
NO of o
peripartum sepsis, 2 due to CPD
m
and 5 due to electrocution. What

oe
y
Child sex ratio
patio > is MMR? cephalo pelvic disproportion
-

Dependency ratio
15
65y
-

Maternal mortality ratio (till i 2 &PP)x

madeaths ↓ Lake ⑨*Maternal mortality rate
;
-
A. 400
maternal deaths
(x2) =
Live birth Llakh 400
U5MR -
deaths
U5 - X
mmR =

X
100,000
x 100
;2
-
·

LB q u 15-19
y B. 4000 2508
IMR -

Infant
-
deaths
x 1000
LB
C. 4
NMR -

dof life x1000;

⑲ PNMR LB
of
0-7d
birth 1000
x

D. 40
--
&

P
25
LB

birth
ut.
still births WKSP04/>1000gm
&
SBR => x get -> >28
Birrns
Child survival index MR
S
10
 Q. In a community of 10000 population, 105 children were born in Communicable and Non-communicable diseases
a year. There were 5 stillbirths, 2 died in the neonatal period due
nowe"ex3-done for Aedes

to prematurity while 2 died in the next 6 months due to diarrhea.

see examined;(5%
House index ne -

(Dengue I yellow
fever)
Calculate the IMR * Larvalpupae 100
Breteau index -ninere examined
-
x
:20
Total no. o Houses

API -new cases x 1000; AP1, 2 0

population at risk
1000
=(2 2) 1000 A x

operational efficiency of programme

3
IMR + ->
ABER slides examined x 100
Best
A. 4 x for
-

-
100
-
population

(105 -
5) SPR -

slides X 108

-
B. 40
-

Total slides examined

C. 9
live births = (05-4)
↑
Quetelet index 1
BMI
=

-2

still births
Births
Ponderal index -(g) 100
x

D. 90 Length (cm)3

(cm) 100
Broca index Ideal Body wt(kg) Height
-
=

Corpulence index a wt.

ideally
<1.2
:

desirable wt.

Miscellaneous
Q. In a community of 100000 people, 5000 slides were examined
Chlorine demand: &x 28 => Amount of Bleaching powder needed
for 155L
I H-O

for malaria. 100 came out to be positive. Calculate the API (norrock's apparatus)
↳ n- jar changing color
Hwye Hundred
dental preg x
cases X ⑦ 1000 Pearl index: dental
preg =
a r 1200 -
- women

AP I -
-
HWY
months I use >
8 using years

Total popul
-
A. 1 Pregnancy wastage factor: 10 %

=e
API Vaccine wastage factor:
B. 10

C. 0.5
ABER - 5000 X 100
- ⑰
D. 2 100000

SPR =) 100 x 100

--

100000
 Q. In a community of 5000 people, CBR is 30 per 1000 people. Q. In a community of 5000 people, CBR is 30 per 1000 people.
The number of pregnant females? The number of pregnant females registered by ANM?

A. 150
CBR

BR for
30/1000 popul
=

this community
-
30
-

1000
x 5008

A. 165
⑳ANC registration 50% I
=
Pregnancy

->
births 165(BR + 10%BR)
preg8
150 ->

-
=

B. 165 B. 150
BR

ageero!R(community
50% xpreg & -so

pregna
C. 185 -
C. 80 Target
-

D. 200 D. 30

-5000
Q. In ae
Q. You went to a subcenter as part of an audit. How many infants
subcentre population, CBR is 30 per 1000 people. The
should be registered with a health worker working there?
number of BCG vaccine doses to be held in the PHC?
subcenter population > 5000
-

Births -> 30
--
x5000 CBR 16.9/100 population
=
17/100
*
popul
1000
-
A. 300 A. 80
~ d
wasted + 2'1.
B >G
subcenter Ex5000-
=
births
85

B. 150 factor B. 100 100

=) 300
vaccines 150x2
=

BCG
C. 165 read. C. 90 IMR = 28
1 1000 popul

d=(BRIsa
↓ Frisa
D. 320 D. 75
for 1000 Lis - 28
dying 80
*

85 ->
-x85
1000
 Q. 20 accidental pregnancies happen after 100 women used a
new contraceptive device for 2yrs. What is the pearl index?

20 x (200
preg. dental ->
Pearl Index= i -

HWY 100 X 2 4
A. 0.1
> 10
=>
Pharmacology
B. 1

C. 5

-
D. 10
-

amountof drug (gm)

Volume of distribution - Q. 4g of drug A is administered to a patient and the plasma
concr (91
concentration is found to be 50mg/l. What is the volume of
distribution? (4]
Half life -

-ae min)
- 0
8o
Clearance
e
=P
-
vd
A. 10l
conce Ud
Loading dose I
--
x
Oh
B. 8l
X
Bioavailability
interval
Maintenance dose - concyclearancexdosing C. 6l
-

infusion rate Bioavailability

D. 4l
Therapeutic index -
-50
TD 50
 Q. A 40 year old male patient weighing 60kg is treated with an
experimental drug which is available as oral tablet with BA of
90%. The Vd is 2L/kg and the desired steady state
concentration is 3mg/l. The clearance is 50ml/min. What is the
most appropriate loading dose?
Q. A 40 year old male patient weighing 60kg is treated with an
experimental drug which is available as oral tablet with BA of
100% given QID. The Vd is 2L/kg and the desired steady state
concentration is 2mg/l. The clearance is 20l/hr. What is the
maintainence dose?

maintainence Long
- 2 20 x 6 2
=
A. 100mg A. 240mg x
=

loading stainability
dose =
dose

B. 150mg B. 160mg
&ID = 6 hourly
C. 360mg C. 300mg
x60)
=> = 400

-
D. 400mg D. 250mg

Q. The LD50 of Drug X is determined to be 500 mg, while the Q. AUC of drug B is 200s while that of drugs A+B is 500s with
ED50 is found to be 50 mg. Calculate the therapeutic index a p-value of 0.03. Which is the true statement?
(TI) of Drug X.

500 10

=
=
=

- I
=

A) 5 -
-
A. Drug A increases renal elimination of drug B
50

-
B) 10 B. Drug A decreases GI absorption of drug B

C) 15 X
C. Drug A decreases first pass metabolism of drug B

D) 0.01 D. Drug A increases first pass metabolism of drug B

 Q. A drug has a half-life of 12 hours. If the initial
concentration of the drug is 200 mg/mL, what would be the
approximate time for the drug to reach steady state
Bioavailability concentration?
I -
T 48-60hrs *

O Ty
12
=
hours

A. 24hrs
-
B. 60hrs

C. 72hrs

D. 120hrs

Q. A drug X was given continuous intravenous infusion at 1.6

mg/min. The clearance of the drug is 640 mL/min. With a half- Q. 200mg of a drug was administered to a patient. 40mg was
life of 1.8 hours, what would be the steady state plasma cleared in 1.5hrs. How much drug would remain in the body
concentration of drug? after 3hrs if the drug follows zero order kinetics?
-

L
↓St order
cone const. amount ↓

me <xSteady state
plasma
fraction
=

eliminated const
A. 2.88 mg/mL A. 25mg de eliminated

3hrs-drug pliminated
6.002
steady
-
state = =

B. 0.004 mg/mL B. 50mg

conc
-
C. 0.002 mg/mL C. 128mg (2x40) I
80mg

D. 3.55 mg/mL D. 120mg

-
remaining 200-80+g
=>

Drug
Q. 200mg of a drug was administered to a patient. 40mg was
cleared in 1.5hrs. How much drug would remain in the body
after 3hrs if the drug follows first order kinetics?

2 wo
mq
↓
-/ 1.5hrs
A. 25mg
-omg
eliminated 1.54Vs Physiology
160
;x
->

⑮
B. 50mg
eliminated
-
C. 128mg > 32
-

⑧
&
D. 120mg left- eliminated
drug
160-32

I 128 mg

- ECF

General physiology Q. Q. A patient injected with 500mg of &

mannitol. The
-> 60'.
-TBW 60%1
-

concentration of mannitol in plasma is 3mg/dl. During the

/ ↳ equilibrium period, 10% mannitol is excreted in the urine.
I CA ECF What is the volume being estimated and which compartment
0
->
Ya
/ (10'1.) (20%) does it belong to?
-
0
213 mannitolgiven =
500mg
(Iabove anything) - -
A. 15l A
Interstitial Plasma 10% excreted I 50mg
fluid fluid B. 25l excreted
(3(1) (4)
-
-

C. 35l
mannitol couche 3mgldh
-> 15 TBW 5% TBW
--

TBW ->
D201720
RISA
Plasma
= Blue
Evans
D. 50l ·
mannitol leftin plasma-P som
(T-1824)

$
3 ⑫F
ICf- cannotbe Mannitol
150dL
(0
- -
Sucrose vol.
=

measured Inulin
Na thiosulfate
 G
Q.A patient injected with D20 and the volume of the fluid was
found to be 48L. If that volume is 60% of the total body
Q. Calculate the tetanising frequency of the skeletal muscle
from the given values: Latent period: 10 msec, Contraction
period: 40 msec, Relaxation period: 50 msec
weight, what is the plasma volume?
5

. . of

mathing
TBW

A. 6l 60% -
> 48 2
-
A. 25Hz
Atraction
o free --

pal
B. 12l 50 48 =4
-
x5
-
B. 50Hz - 10 = 25 H2
& 8x1x1 60 -
~C. 4l
-
3 ↑ ↑O
C. 2.5Hz
↑ ↑
D. 18l =
⑫f (Plasma vol)
D. 250Hz

Q. A patient got his SBP reduced by 10 mm of Hg when he

Q. Sodium concentration is 140 mmol/L, glucose
stood up and he regained only 8 mm of Hg. What was the
concentration is 90 mg/dL, and BUN concentration is 14
gain?
mg/dL. Calculate the serum osmolarity

- -
2
correction

amazing
A. 2 Gam I
A. 290 +20
(glose]
-

error 2xma+
=

28
-
-
B. -4 B. 280

8 My ⑳
C. 4
gain C. 285
I
mm
-

2mm rg
10+
D. -2 D. 295
I
2x140 +
scum osm ->

18
as BP is reducing
2) 290
General physiology
Q. A patient's tidal volume (Vt) is 600 mL, and their
I
Tetanizing frequency i- respiratory rate (RR) is 15 breaths per minute. During PFT,
contraction period patient has dead space of 150ml, FRC of 2l, ERV of 1.5l and
correction TLC of 6l. Calculate the alveolar ventilation rate.
Gain I
--

error

Serum osmolarity =
2xNa] +

(se) +I -
A. 6.7l/min eventilation Rate (
=
-
xx) x MR

B. 5l/min
> (600 150) 15
x -6750
=>
-

C. 9l/min
dead - 150mL
T =>
space
D. 10l/min

Q. A patient's tidal volume (Vt) is 500 mL, and their

respiratory rate (RR) is 15 breaths per minute. During PFT,
patient has dead space of 200ml, FRC of 2l, ERV of 1.5l and Q. At an altitude of 1300ft, the barometric pressure is 447mm
TLC of 6l. Calculate the residual volume Hg. What is the Pi02?

fioz
(PBarometeric Provapoan)
elegal
- *
FRC ERV
Pioz
- =

-
A. 500ml volume A. 60mm Hg
-
B. 250ml B. 84mm
- Hg
Preo vapour ↑1 mm
=

Ay
C. 200ml C. 72mm Hg
FiOz 21%
=

D. 100ml D. 50mm Hg
Q. Calculate respiratory quotient (RQ) in a patient with 50kg Q. Tidal volume of a person is 500 ml. Intrapleural pressure
body weight, CO2 exhaled 200m//min, and O2 consumed before inspiration = -4 cmH20 and after inspiration = -9
250ml/min cmH20. Compliance of the lungs is:

-
A. 0.8

B. 1.2
⑳ ~
A. 100

B. 0.01
arrance
0 =

A
↳P

RO I 200
C. 1 - - C. 1 - 500
250 -

5
D. 0.6 D. 0.1

Respiratory physiology RENAL PHYSIOLOGY

MINUTE VENTILATION TV
=
XRR

RR
Clearance=
E feNa
a xPreat
=(Tv -TD)
=

x
ALVEOLAR VENTILATION
->
PraXUcreat V
I
- GFR= Glearance) envin(estimated GFR=(C) creat.
Compliance -

vol. If dead space Fena

> Wax p
ata
=>

Ucreat
RPF= (c) par
IRV IC
Filtration fraction= R 201
>-
;

VC RPF
excretion load
TV TLC Reabsorption rate- filtered load -

(Px GFR)
x (Ux -

Xplowrate)
ERV (Clearance) Nat
FRC FeNa- -

GAR
RV
Clearance: PAH > Creatinine > Inulin > Urea > Na > Glucose
Q. A patient's urine flow rate is 1.2 mL/min. The concentration
of a substance X in their urine is 60 mg/mL, and the
Q. Calulate the net filtration pressure:
concentration of the same substance in their plasma is 0.5
Glomerular hydrostatic pressure (PGC): 60 mmHg
mg/mL. What is the likely behavior of the kidney with the
substance X Bowman's capsule hydrostatic pressure (PBC): 15 mmHg
Plasma colloid osmotic pressure (πGC): 25 mmHg
Imi
Y 160
=
=

x =

60 15 -
25 =)20
+ = -

-
A. Tubular secretion -
A. 20
100-10mL/min
B. Freely filtered ⑭ GFR =

B. 10
Secretion
Tubular
> GFR =)
C. Tubular reabsorption C. 60
CLLGFR
=> Tubular reabsorptio
D. Neither secretion nor reabsorbtion CL GFR
=
E
Freely filtered D. 70

CVS PHYSIOLOGY
cardiac output Or consumption Q. What is the cardiac output of a patient when arterial 02 is
Fick’s law: I
-
20 ml/dl and venous 02 is 16 ml/dl and whole body oxygen
Arterial O2-venous O2
consumption 300 ml/min:

LMET O, consumed
= rest=
at 3.5m2/kg/min
MET:
A. 7.5ml

alle's
equ
3
↑ density,
B. 7.5l co =

Blood vessel -- peed

radius o
-

↳ diameter C. 7.5dl
Raynauld's
no
->
viscosity D. 75ml
-
Es Bu
Length of
I <2000=) laminal
viscosity flow
 Q. P-V curve of a patient with a HR of 80bpm is shown.
Q. Calulate the MET equivalent of 1500ml of oxygen Calculate the Cardiac output and EF of the patient.
consumption per minute for healthy 70kg adult male stroke vol. 7o
=

-
A. 5.6l, 58%
. Su MR
x

3.5x70/min =) 245milmin 20 80
70 x
= 5.6L

⑱-
=

A. 2 1 mer =

B. 9
B. 5.6l, 53%
Fi
x fraction
-

C. 6.4l, 55% Ef 20 x 100

=

58.3%.
->

-
C. 6
120

150 ⑧ => D. 6.4l, 56%

D. 10 MET equivalent -

250
↓
↓
ESU EDU
 Acid-base imbalance
CO2 =) Acid

I
pH 7.4
2

Co2 ↑O ⑪ values ⑦ Base

=

HCO3
-

HCo3- 24

pH PRIMARY CHANGE COMPENSATION compensation

Adequate
↓
ACID-BASE IMBALANCE METABOLIC
A
HCO3 t
t
winter'sformula
CO2
ACIDOSIS
CO2 (.5xHC03#8) 12
=

METABOLIC 4
ALKALOSIS ↑ H203 CO2 4 Every Imm ↑ 4C03
by 0-7mmCO2 -

RESPIRATORY Acute - no, byd

ACIDOSIS t CO2 for every
10mm a
4 co,
4
Chronic > Hos by
-

CO2
by
Mco.
RESPIRATORY Acute -> Host 2
9 CO2 ↓ for every ↓
ALKALOSIS
10mm L Chronic--Host by 5

On laboratory investigations in a patient, pH=7.3, A patient is having pH-7.12, HCO3-28 and PCO2-50
pCO2=35 mm Hg, What is the likely acid base mm Hg. What is the acid base disorder in this
imbalance? patient? 0 Acidosis
PH-1.12- pCoc4=) Respiratory
Adosis]
pr 7.3
+ =

metabolic
poz Hg
= 35 mm
Acidosis
A. Metabolic acidosis with respiratory compensation
. respiratory
A. Respiratory acidosis Acidosis

B. -
Metabolic alkalosis with respiratory compensation ⑦
-B. Metabolic acidosis - ⑧
HCOB ->
-
-C. Respiratory acidosis with renal compensation G
C. Metabolic alkalosis
. Some renal
D. Respiratory alkalosis with renal compensation
compensation
-
D. Respiratory alkalosis
 A patient has the following arterial blood values:
pH=7.52 ->Alkalosis The ABG analysis findings of a patient are given
Pco2=20 mm Hg -> Respi RespiAikalosis I metab.
compensat below. Which of the following is the likely diagnosis?
HCO3= 16 mEq/L pH:7.2 Acidosis
->

Which of the following statements is correct? HCO3: 10 mEq/L -> metabolic

Metabacidosis:
relpensation
↓
PaC02: 25 mmHg *
A) He is hypoventilating -> C02 :.
Anion gap: 15
-
⑭ As = 12 I
B) Appropriate renal compensation would cause his arterial bicarbonate to
check Delta
increase X
-
gap
C) He has almost complete respiratory compensation venal A. Metabolic acidosis plus respiratory acidosis A
gap DAY
=
-

DHCO3
~
- -

-
D) He has decreased ionized Ca in blood (A4-12)
=> -

(420, -21)
d
B. High anion gap metabolic acidosis plus metabolic alkalosis
Acidosis
alkalosis car 1- cat bounds to Agap -> > 6 + + Metab.

free
-
C. High anion gap metabolic acidosis only L- 6 - +
NAGMA

Albumin -
6 to 6
+
+ +
HAGMA
-
-
D. High anion gap plus normal anion gap metabolic acidosis
-.. Bound Cart I
gap=(3 -1P)
& => -
11