Q:

Which of the following statements are true of elevated–anion gap metabolic acidosis?

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Which of the following statements are true of elevated–anion gap metabolic acidosis?


  1. Hypoperfusion from the shock state rarely produces an elevated anion gap
  2. Retention of sulfuric and phosphoric acids may lead to this form of acidosis.
  3. Copious diarrhea does not produce this condition.
  4. Rapid volume expansion may produce this form of acidosis.
  5. Use of lactated Ringer\'s solution is inappropriate in the treatment of lactic acidosis.

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B. Retention of sulfuric and phosphoric acids may lead to this form of acidosis.

C. Copious diarrhea does not produce this condition.

DISCUSSION: An elevated anion gap may be produced by lactic acidosis from shock or by retention of inorganic acids from uremia. Lactated Ringer's solution rapidly corrects the lactic acidosis from hypovolemia, as lactate is converted to bicarbonate with hepatic reperfusion. Bicarbonate loss from diarrhea and “dilutional acidosis” are non–anion gap types of metabolic acidosis.

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