This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Nutrition, Subject name: Medicine
[{'content': 'Which causes hyperchloremic metabolic acidosis \nSelect and explain. \nA. Ethylene glycol poison, B. DKA, C. Lactic acidosis, D. Diarhhea', 'role': 'user'}, {'content': 'Answer: D \nExplanation: The causes of a hyperchloremic metabolic acidosis is a loss of the base, either a gastrointestinal loss or a renal loss.Gastrointestinal loss of bicarbonate (HCO-3)Severe diarrhoeaPancreatic fistula with loss of bicarbonate-rich pancreatic fluidNasojejunal tube losses in the context of small bowel obstructionChronic laxative abuseRenal causesProximal renal tubular acidosis with a failure of HCO-3 resorptionDistal renal tubular acidosis with a failure of H+ secretionLong-term use of a carbonic anhydrase inhibitor such as acetazolamide', 'role': 'assistant'}]