Renal medicine: renal tubular acidosis: practice question

A General Medicine question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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General Medicine · Renal medicine: renal tubular acidosis

Sample item

A patient has normal-anion-gap metabolic acidosis, hypokalemia, nephrolithiasis, and urine pH persistently above 5.5. Which disorder is most likely?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Distal renal tubular acidosis

Distal renal tubular acidosis reflects impaired hydrogen secretion in the collecting duct, causing inability to acidify urine, hypokalemia, and calcium phosphate stones. It produces a normal-anion-gap metabolic acidosis.

Option by option

  • A. Proximal renal tubular acidosis only

    Proximal RTA can acidify urine once serum bicarbonate falls and is less stone-prone.

  • B. Respiratory acidosis

    Respiratory acidosis has elevated carbon dioxide.

  • C. Diabetic ketoacidosis

    DKA causes high-anion-gap metabolic acidosis with ketones.

  • D. Distal renal tubular acidosis (correct)

    Correct. Alkaline urine with stones and acidosis points to distal RTA.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this General Medicine question

What is the answer to this General Medicine question?

The best answer is D, Distal renal tubular acidosis. Distal renal tubular acidosis reflects impaired hydrogen secretion in the collecting duct, causing inability to acidify urine, hypokalemia, and calcium phosphate stones.

Why is "Proximal renal tubular acidosis only" not the answer?

Proximal RTA can acidify urine once serum bicarbonate falls and is less stone-prone.

Why is "Respiratory acidosis" not the answer?

Respiratory acidosis has elevated carbon dioxide.

Why is "Diabetic ketoacidosis" not the answer?

DKA causes high-anion-gap metabolic acidosis with ketones.

What concept does this question test?

It tests Renal medicine: renal tubular acidosis in General Medicine. It produces a normal-anion-gap metabolic acidosis.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Renal medicine: renal tubular acidosis?

For each disease know the classic presentation, the best test, and the first-line treatment. Then use the flashcards and the other General Medicine questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.