Normal anion gap acidosis seen in: March 2005

Ans. B: CholeraA normal anion gap metabolic acidosis occurs when loss of bicarbonate from the GI tract or kidneys is excessive or when hydrogen ions cannot be secreted because of renal failure. The causes can be represented by the mnemonicUSEDCARP:UreterostomySmall bowel fistulaExtra chlorideDiarrheaCarbonic anhydrase inhibitors (e.g., acetazolamide)Adrenal insufficiencyPancreatic fistulaAn elevated anion gap is created by inorganic (e.g., phosphate or sulfate), organic (e.g., ketoacids or lactate), or exogenous (e.g., salicylate) acids incompletely neutralized by bicarbonate. Frequent causes of an elevated anion gap metabolic acidosis is represented by the mnemonic MUDPILES:MethanolUremiaDiabetic ketoacidosisParaldehydeIron, isoniazid (INH)Lactic acidEthanol, ethylene glycolSalicylates