Distal Renal tubular acidosis is associated with the following EXCEPT
Correct Answer: Urine pH <5.5
Description: Ans. b (Urine pH < 5.5) (Ref: Harrison's 17th ed/Table 278.2)DISTAL RENAL TUBULAR ACIDOSIS# hyperchloremic acidosis.# minimum urine pH >5.5 in the presence of systemic acidosis.# If doubt, an ammonium chloride loading test is performed (Patients with distal RTA will not make urine pH < 5.5).# Hypercalciuria, an alkaline urine, and a low urine citrate level increase urine saturation with respect to CaP04.# Calcium phosphate stones form, nephrocalcinosis is common, and osteomalacia or rickets may occur.# RX: with supplemental alkali reduces hypercalciuria and limits the production of new stones.# Incomplete RTA may develop in some patients who form calcium oxalate stones because of idiopathic hypercalciuria; the importance of RTA in producing stones in this situation is uncertain, and thiazide Rx is a reasonable alternative.INHERITED TUBULAR DISORDERSDiseaseMode of InheritanceRenal abnormalitiesExtra-renal abnormalitiesType 1 Bartter's syndromeARSalt wasting; hypokalemia Type 2 Bartter's syndromeARSalt wasting; hypokalemia Type 3 Bartter's syndromeARSalt wasting; hypokalemia Type 4 Bartter's syndromeARSalt wasting; hypokalemiaSensorineural deafnessType 5 Bartter's syndromeADSalt wasting; hypokalemia Gitelman's syndromeARSalt wasting; hypokalemia; hypomagnesemia Pseudohypoaldosteronism Type ARHyperkalemia; salt wastingIncreased lung secretions and inf ADHyperkalemia; salt wasting Primary hypomagnesemiaARHypomagnesemia; nephrocalcinosisHypomagnesemia withARHypomagnesemia; hypocalcemiasecondary hypocalcemia Renal magnesium wastingADHypomagnesemia; hypocalciuriaAutosomal dominantADHypocalcemia; hypercalciuria; hypoparathyroidism hypomagnesemia Liddle's syndromeADHypertension; hypokalemia; alkalosisPseudohypoaldosteronismADHypertension; hyperkalemia Type II (Gordon syndrome) Nephrogenic Dl Type 1XLRenal concentrating defect Nephrogenic Dl Type 2AR, ADRenal concentrating defect Nephrogenic syndrome of inappropriate antidiuresisXLHyponatremia Distal renal tubular acidosisARHyperchloremic metabolicSensorineural deafness acidosis; nephrocalcinosis(B1 defect only); growth retardation ARProximal and distal RTA ADDistal RTA Proximal renal tubular acidosisARModerate hyperchloremic metabolic acidosisGlaucoma; band keratopathyCystinuriaARCystine stones; dibasic amino aciduria Hartnup diseaseARNeutral amino aciduria dementiaRash, dermatitis, ataxia;Dent's diseaseXLProximal tubular dysfunction; nephrocalcinosisOsteomalacia; ricketsRenal glycosuriaARGlucosuria Hereditary hypophosphatemicARHypophosphatemia;Ricketsrickets with hypercalciuriahypercalciuria Vitamin D-dependent rickets type 1ARHypocalcemiaRickets
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