Question

a 22-year-old college student presents to the emergency room with a 2-day history of severe vomiting and orthostatic hypotension. which of the following metabolic abnormalities are most likely present in this patient.

a normal serum electrolytes and metabolic acidosis

b hypokalemia and metabolic alkalosis

c hypokalemia and metabolic acidosis

d Hyperkalemia and metabolic alkalosis

E normal serum electrolytes and metabolic alkalosis

Answer 1

Ans b. Metabolic Alkalosis with hypokalemia

Severe vomitting causes Loss of gastric juice which leads to loss of H+ ion, Chloride, potassium

Loss of Hydrogen ion causes -- Metabolic Alkalosis

Loss of Potassium -- Hypokalemia

Loss of chloride --- hypochloremia

The gastric acid produced by the gastrointestinal tract contains hydrochloric acid and smaller quantity of potassium chloride.

When HCl is lost through vomiting, pancreatic secretions are not stimulated and a net gain of bicarbonate into the systemic circulation occurs, generating a metabolic alkalosis. Volume depletion maintains alkalosis. In this case, the hypokalemia is secondary to the alkalosis itself and to renal loss of potassium ions from the stimulation of aldosterone secretion.