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Medicine Fluid & Electrolyte 506ba226

Metabolic alkalosis is seen in

A
Primary mineralocorticoid excess
B
Deficiency of mineralocorticoid
C
Decreased acid excretion
D
Increased base excretion
High-Yield Explanation
Ans. is 'a' i.e., Primary mineralocorticoid excess * Mineralocorticoid excess increases net acid excretion, this leads to metabolic alkalosis.Also knowThe plasma potassium concentration changes with serum pH.If pH decreases the excess H+ tends to enter the body's cells in exchange for K+ and plasma increases.If the pH increases (alkalosis) H+ tends to leave cells and enters bloodstream to partly compensate for the alkalosis.In exchange for H\ K+ enters the cells and results in decreased plasma hypokalemic alkalosis.Causes of Metabolic AlkalosisExogenous HCO3' loadsAcute alkali administrationMilk-alkali syndromeEffective ECFV contraction, normotension, K+ deficiency, and secondary hyperreninemic hyperaldosteronismGastrointestinal originVomitingGastric aspirationCongenital chloridorrheaVillous adenomaCombined administration of sodium polystyrene sulfonate (Kayexalate) and aluminum hydroxide.Renal originDiureticsEdematous statesPost hypercapnic stateHypercalcemia/hypoparathyroidismRecovery from lactic acidosis or ketoacidosisNonabsorbable anions including penicillin, carbenicillinMg2+deficiencyK+ depletionBartter's syndrome (loss of function mutations in TALH)Gitelman' s syndrome (loss of function mutation in Na+-Cl- cotransporter in DCT)ECFV expansion, hypertension, K+ deficiency, and mineralocorticoid excessHigh reninRenal artery stenosisAccelerated hypertensionRenin-secreting tumorEstrogen therapyLow reninPrimary aldosteronismAdenomaHyperplasiaCarcinomaAdrenal enzyme defectslip - Hydroxylase deficiency17a - Hydroxylase deficiencyCushing's syndrome or diseaseOtherLicoriceCarbenoxoloneChewer's tobaccoLydia Pinkam tabletsGain of function mutation of renal sodium channel with ECFV expansion, hypertension, K+ deficiency, and hyporeninemic- hypoaldosteronismA.Liddle's syndromeThis is the complete list of metabolic alkalosis the list given in answer 32 is not complete.

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