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A patient in a rural hospital in India was diagnosed with "metabolic alkalosis" but the chart did not include information on the history or physical exam. There was also no lab data. Which of the following is a potential cause of metabolic alkalosis?

Explanation

•Hyperaldosteronism increases nephron ion transport of sodium and hydrogen. H+ excretion in the distal tubule is exchanged for HCO3 reabsorption, leading to metabolic alkalosis.

Respiratory Acidosis:
•Respiratory system is the cause
•Increase in PCO2, decrease in pH
•Compensation - Kidneys reabsorb Bicarb (HCO3)

Metabolic Acidosis:
•Caused by loss of bicarb or build up of acids - Lactic acidosis, diarrhea, renal failure, ketones, ammonium intoxication. Not caused by respiration.
•HCO3 decreases, pH decreases
•Compensation - hyperventilation to eliminate CO2

Respiratory Alkalosis:
•Caused by excessive ventilation
•Decrease in PCO2, increase in pH
•Compensation - Kidneys excrete HCO3

Metabolic Alkalosis
•Acid (H+) loss from emesis, diuretics.Or retention of HCO3 from medications, hyperaldosteronism
•Increase in HCO3, Increase in pH
•Compensation - Repiratory centers are not stimulated, this leads to hypoventilation and CO2 retention

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