A patient of CKD has presented with protracted vomiting. ABG shows pH = 7.40, pCO2 = 40 mm Hg, HCO3 = 25 mEq, Na=145 mEq/L, Chloride = 100 mEq/L, HCO3 = 24 mEq/L. What is the observation?
Normal anion gap metabolic acidosis
High anion gap metabolic acidosis
No acid base abnormality
High anion gap metabolic acidosis and metabolic alkalosis
AG(Anion Gap)= Na+ - (Cl- + HCO3-) = 145-124 = 21 meq Normal 8-10meq Rules out option a. - CKD is condition where patient experiences impaired ability to excrete H+ - Vomiting contributes to metabolic alkalosis - Two processes simultaneously occurring So answer is High anion gap metabolic acidosis and metabolic alkalosis.