A 66-Year-Old Man Is Hospitalized for Elective Surgical Repair of an Abdominal

A 66-year-old man is hospitalized for elective surgical repair of an abdominal aortic aneurysm.  The patient has had midabdominal and low back pain due to an enlarging infrarenal aortic aneurysm.  Medical history also includes hypertension and prolonged tobacco use.  Preoperative cardiopulmonary examination is normal, and blood cell counts and serum chemistry studies are within normal limits.  During the surgery, prolonged clamping of the infrarenal aorta and iliac arteries is required due to complex aneurysm anatomy, but there are no other intraoperative complications.  The patient's postoperative laboratory results are as follows: Over the next several hours, which of the following changes is most likely to occur in this patient in response to the acid-base imbalance?

A) Decreased central respiratory drive
B) Decreased renal carbonic anhydrase activity
C) Decreased urinary titratable acid excretion
D) Increased urinary ammonium excretion
E) Increased urinary chloride reabsorption

Correct Answer:

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