American Board of Internal Medicine (ABIM) Certification Practice Exam

What is the correct dosage of oral sodium bicarbonate for patients being treated?

1. 1 mEq/kg/d

2. 0.5 mEq/kg/d

3. 2 mEq/kg/d

4. 0.25 mEq/kg/d

The correct answer is: 0.5 mEq/kg/d

The appropriate dosage of oral sodium bicarbonate for patients requires careful adjustment based on the individual's clinical condition, particularly in the context of metabolic acidosis or renal disease. In practice, the recommended dosage often falls around 0.5 mEq/kg/d, which allows for a balance—providing sufficient buffering capacity while minimizing the risk of complications such as alkalosis. This dosage is particularly useful in maintaining adequate serum bicarbonate levels without overshooting, which could lead to metabolic alkalosis. It is critical to monitor the patient's bicarbonate levels regularly to ensure they remain within a target range, as excessive supplementation can have adverse effects. When considering treatment protocols, it is essential to assess each patient's specific needs, including their underlying conditions and any concurrent treatments being administered, as this can influence the effectiveness and safety of sodium bicarbonate therapy.