Increased anion gap acidosis is seen in -a) DKAb) RTA c) ARFd) Organic aciduriae) Diarrhoea
**Core Concept**
Increased anion gap acidosis occurs when the difference between the measured sodium and chloride concentrations exceeds 10 mEq/L, indicating the presence of unmeasured anions in the blood. This type of acidosis is often caused by metabolic disturbances that result in the accumulation of acidic substances, such as lactic acid, ketoacids, and organic acids.
**Why the Correct Answer is Right**
The correct answer, **D. Organic aciduria**, is right because organic acidurias are a group of disorders that result in the excessive production of organic acids in the body. These acids can accumulate and cause an increase in the anion gap, leading to metabolic acidosis. Examples of organic acidurias include methylmalonic acidemia, propionic acidemia, and isovaleric acidemia. In these disorders, the body is unable to properly metabolize certain amino acids, leading to the accumulation of toxic organic acids.
**Why Each Wrong Option is Incorrect**
**Option A:** DKA (Diabetic Ketoacidosis) is a cause of non-anion gap metabolic acidosis, not increased anion gap acidosis.
**Option B:** RTA (Renal Tubular Acidosis) can cause hyperchloremic metabolic acidosis, which is characterized by a normal or decreased anion gap.
**Option C:** ARF (Acute Renal Failure) can lead to non-anion gap metabolic acidosis due to the accumulation of acid in the body and failure of the kidneys to excrete it properly.
**Clinical Pearl / High-Yield Fact**
Remember the mnemonic "MUDPILES" to help you remember the causes of increased anion gap acidosis: M - Methanol, U - Uremia, D - Diabetic Ketoacidosis, P - Paraldehyde, I - Isoniazid, L - Lactic acidosis, E - Ethylene glycol, S - Salicylates.
**Correct Answer: D. Organic aciduria**