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In type II RTA, the plasma HCO3– cannot be restored to the normal range. HCO3– replacement should exceed the acid load of the diet. Additional HCO 3– replacement increases potassium bicarbonate losses in the urine. Citric acid/sodium citrate (Bicitra) or potassium citrate/citric acid (Polycitra-K) can be substituted for sodium bicarbonate and may be better tolerated. Potassium supplements may be required in patients who become hypokalemic when given sodium bicarbonate, but are not recommended in patients with normal or high serum potassium levels.

Anticholinergic or other drugs, fecal impaction). Urinary retention not obviously resulting from a transient cause generally requires further evaluation, including cystometry, to determine why the bladder does not empty properly. The PVR urine volume can be measured by one of two methods. The first and most common method is “in and out” urethral catheterization after the patient has urinated to empty the bladder. The quantity of urine obtained is measured. PVR volume can also be measured with pelvic ultrasonography.

Category: Respiratory system 30. Angioneurotic edema is associated with the use of A) ACE inhibitors B) β-Blockers C) Loop diuretics D) α-Receptor blockers E) CCBs Answer and Discussion The answer is A. 2% of patients, usually develops within the first week of therapy but can occur at any time. This life-threatening adverse effect also occurs with angiotensin 60 II-receptor blockers, but to a lesser extent. Any patient with a history of angioneurotic edema, whether related to an ACE inhibitor, ARBs, or another cause, should not be given an ACE inhibitor.