Metabolic Acidosis
Sodium bicarbonate is indicated in a patient with metabolic acidosis associated with respiratory failure
What our notes say
- Sodium bicarbonate is indicated in a patient with metabolic acidosis associated with respiratory failure (Paediatrics Year 6 MBChB end of semester CAT: clinical case MCQs, 29 of 30 quest)
- Correction of metabolic acidosis in a patient with asymptomatic hypocalcaemia is likely to be associated with tetany (Paediatrics Year 6 MBChB end of semester CAT: clinical case MCQs, 29 of 30 quest)
- DKA is a medical emergency in insulin deficiency, with the triad of hyperglycaemia (glucose above 11 mmol/L), ketonaemia or ketonuria, and metabolic acidosis (pH below 7.3 or bicarbonate below 15 mmol/L). (Chemical Pathology Practice Examination)
- The patient passes profuse watery "rice water" stools with vomiting, rapid dehydration and shock, hypokalaemia and metabolic acidosis. (Internal Medicine CAT 1 (MBIM 6112), 2019/2020: gastroenterology and hepatology,)
- They also cause metabolic acidosis, high potassium, high phosphate and high uric acid. (Paediatrics main exam (MBPE 4300): 24 January 2022, Paper One, 100 MCQs, 2 short)
- Non-cardiorespiratory Anaemia, Metabolic acidosis , Obesity (Examination of Respiratory system — Past Paper Questions & Answers)
Study material on Metabolic Acidosis
- Chemical Pathology MCQs
- Chemical Pathology MCQs: Clinical Chemistry, Endocrine & Renal
- Chemical Pathology Sem 1
- Chemical Pathology Practice Examination
- Medical MCQs: Chemical Pathology & Haematology Exam Review
- Chemical Pathology Practice Examination
- Chemical Pathology MCQs: Diabetes, Renal & Liver Disease
- Renal, Liver, Cardiac & Adrenal Function Tests for Year 3
- Chemical path 2021
- Chemical Pathology Semester 1 — Short Answer Questions
- Chemical Pathology MCQs
- ACIDOSIS AND ALKALOSIS MCQs
- Weekly Year 2: Physiology Exam - May 29, 2026 (Section A: MCQs)
Practice questions on Metabolic Acidosis
Which of the following is a component of the renal response to metabolic acidosis?
- reabsorption of H+
- secretion of HCO3- into the tubular lumen
- secretion of ammonium into the tubular lumen
- secretion of glutamine into the interstitial fluid
- Usually mediated by non-specific mechanisms
Answer: C. During metabolic acidosis, the kidneys compensate by increasing acid excretion and bicarbonate regeneration. Ammonium (NH4+) secretion into the tubular lumen is a major mechanism for eliminating excess acid from the body. ---
A 19-year-old with abdominal pain, Kussmaul breathing, high ketones and metabolic acidosis most likely has:
- Hyperosmolar hyperglycaemic state
- Diabetic ketoacidosis
- Addison crisis
- Thyroid storm
- SIADH ✅ Answer: B
Answer: A. Abdominal pain, Kussmaul breathing, high ketones, and metabolic acidosis are the hallmark features of diabetic ketoacidosis (DKA).
An increased anion gap metabolic acidosis can be caused by
- Diarrhea
- Lactic acidosis
- Renal tubular acidosis
- Hyperaldosteronism Correct
Answer: B. Lactic acidosis causes increased anion gap metabolic acidosis due to organic acid accumulation. Diarrhea and RTA typically cause normal anion gap acidosis. ---
Which of the following causes a normal anion gap metabolic acidosis?
- Lactic acidosis
- Methanol toxicity
- Renal tubular acidosis
- Diabetic ketoacidosis Correct
Answer: C. RTA causes normal anion gap acidosis due to impaired renal acid excretion. Other options cause high anion gap acidosis. ---
A patient with metabolic acidosis and an increased anion gap likely has
- Renal tubular acidosis
- Diabetic ketoacidosis
- Hyperaldosteronism
- SIADH Correct
Answer: B. DKA produces ketoacids, causing high anion gap metabolic acidosis. RTA causes normal anion gap acidosis. ---
Which compensatory response occurs in metabolic acidosis?
- Decreased respiratory rate
- Increased respiratory rate
- Increased bicarbonate
- Increased CO₂ retention Correct
Answer: B. Metabolic acidosis triggers hyperventilation to blow off CO₂ and partially compensate for the acidosis. ## Case-Based MCQs Section 1: Electrolytes & Acid-Base Disorders ---