Normal anion gap metabolic is caused by :

Answer is A (Cholera) Cholera is a cause of normal anion gap metabolic acidosis produced as a result of loss of bicarbonate in the faeces. Metabolic acidosis with normal anion gap : Normal anion gap in the presence of acidosis suggests that either, WC(); is retained or that Na+ HCO3- is being lost. Increased Gastrointestinal bicarbonate loss Decreased renal hydrogen ion excretion Diarrhoea Distal (type 1) renal tubular acidosis Ileostomy Type 4 renal tubular acidosis (aldosterone deficiency) Ureterosigmoidostomy Increased renal bicarbonate loss Increased 1-1C1 production Acetazolamide Ammonium chloride ingestion Proximal (type 2) renal tubular acidosis Increased catabolism of lysine, arginine Hyperparathyroidism Tubular damage, e.g. drugs, heavy metals, paraproteins Causes of normal anion gap metabolic acidosis : Diarrhea (Cholera), Fistula, Ureterosigmoidostomy Renal Tubular Acidosis Ingestion of Ammonium Chloride Mineralocoicoid deficiency