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USMLE Step 1 Questions
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An 18-year-old female athlete reports easy fatigability and weakness. Physical examination shows no abnormalities. Laboratory studies are above. Which of the following is the most likely diagnosis?
Correct Answer: E. Surreptitious use of diuretics
This patient’s serum bicarbonate is high, while her potassium is low. The potassium level in her urine is high. (Typical range is 50-150mEq per day). This indicates the use of a diuretic which blocks the reuptake of potassium.
Choice A is incorrect because aldosterone increases potassium secretion, therefore aldosterone deficiency would cause decreased potassium secretion.
Choice B is incorrect because hyperventilation causes respiratory alkalosis, resulting in decreased bicarbonate in the serum.
Choice C is incorrect because acidosis causes decreased potassium secretion. Also, diabetic ketoacidosis would cause additional symptoms and abnormally high blood glucose levels.
Choice D is incorrect because ingestion of anabolic steroids generally does not cause the type of potassium imbalance indicated by the lab values.
1. QuestionCategory: Pathophysiology
An 18-year-old female athlete reports easy fatigability and weakness. Physical examination shows no abnormalities. Laboratory studies are above. Which of the following is the most likely diagnosis?Correct