Progressive Fatigue in Medicine / Internal Medicine — 30yo Woman | Nephrology | SMLE Q#12056

SMLE Question #12056

Medicine / Internal Medicine Nephrology

Objective: OBJ-188

Last updated: February 2026
A 30-year-old woman with known Sjögren syndrome on hydroxychloroquine presents with progressive fatigue. She denies vomiting, diarrhea, or diuretic use. Physical examination is unremarkable. Serum chemistry shows a normal anion gap metabolic acidosis with hypokalemia, and urinalysis shows an inappropriately alkaline urine. Which type of renal tubular acidosis is most likely responsible for her hypokalemia?

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