This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Electrolyte Imbalance, Subject name: Medicine
[{'content': 'A patient of Chronic Kidney disease is having protracted vomiting. ABG repo is pH= 7.4, pCO2 =40 mm Hg, HCO3= 25 meq, Na= 145 meq and Chloride s 100 meq. Diagnosis is? \nSelect and explain. \nA. Normal anion gap metabolic acidosis, B. High anion gap metabolic acidosis, C. No acid base abnormality, D. High anion gap metabolic acidosis and metabolic alkalosis', 'role': 'user'}, {'content': 'Answer: D \nExplanation: CKD leads to metabolic acidosis while vomiting leads to metabolic alkalosis. The key to the answer is anion gap which is elevated to 25 implying unmeasured anions. (Normal average of 10 meq). It points to mixed etiology of metabolic acidosis and alkalosis. Normal values of pH, pCO2 and HCO3 does not ensure absence of acid base imbalance.', 'role': 'assistant'}]