Persistent vomiting in G.O.O. causes -a) Hyponatremic hyperchloremia occurb) Hypernatremia without |ed Cl- alkalosisc) Hypokalemic metabolic alkalosisd) Paradoxical aciduria

Repetitive vomiting leads to hypochloremic, hypokalemic metabolic alkalosis. The urine is alkaline initially but eventually it becomes acidic (paradoxical aciduria) Cause of paradoxical aciduria Initially the kidney compensate for metabolic alkalosis by reabsorbing hydrogen and chloride ions in exchange for sodium, potassium and bicarbonate. But gradually as the body stores of sodium and especially potassium become depleted, kidney stas retaining these ions in exchange of hydrogen ions, thus the urine becomes acidic and metabolic alkaline state is fuher aggravated. Ref : Schwaz 9/e p1426