Neonatal Nurse Practitioner Practice Exam

Which of the following are common causes of metabolic acidosis with a high anion gap?

1. Renal dysplasia and obstructive uropathy

2. Lactic acidosis and acute renal failure

3. Hypothyroidism and renal dysplasia

4. Chronic liver failure and diabetic ketoacidosis

The correct answer is: Lactic acidosis and acute renal failure

In the context of metabolic acidosis with a high anion gap, the correct response highlights lactic acidosis and acute renal failure as common causes. Lactic acidosis occurs when there is an accumulation of lactic acid in the body, often due to tissue hypoxia, sepsis, or strenuous exercise, leading to a significant increase in the anion gap. Acute renal failure can also contribute to high anion gap metabolic acidosis by reducing the kidney's ability to excrete acids and resulting in the accumulation of unmeasured anions such as sulfate and phosphate. Together, these conditions are well-known and clinically recognized causes of high anion gap metabolic acidosis. The other options, while they may be associated with metabolic acidosis, do not commonly present with a high anion gap. Renal dysplasia and obstructive uropathy primarily lead to a different type of metabolic acidosis related to bicarbonate loss or retention of acid rather than an increase in unmeasured anions. Hypothyroidism is not a primary cause of metabolic acidosis, and while renal dysplasia can impact renal function, it does not typically manifest with a high anion gap. Chronic liver failure can cause metabolic acidosis, but it is more often associated