Hypochloremic alkalosis is seen in: March 2009
**Core Concept**
Hypochloremic alkalosis is a type of metabolic alkalosis characterized by a low chloride ion concentration in the blood, resulting in an increase in blood pH. This condition is often caused by excessive loss of hydrogen and chloride ions from the body, leading to a decrease in chloride levels and an increase in bicarbonate levels.
**Why the Correct Answer is Right**
The loss of hydrogen and chloride ions from the body can occur through various mechanisms, including vomiting, diarrhea, or excessive use of diuretics. When stomach acid is lost through vomiting, it leads to a decrease in hydrogen and chloride ion levels in the blood. The kidneys compensate for this loss by increasing the reabsorption of bicarbonate ions, which further contributes to the development of hypochloremic alkalosis. This condition is often seen in patients with severe gastrointestinal disorders, such as pyloric stenosis or gastritis.
**Why Each Wrong Option is Incorrect**
* **Option A:** This option is incorrect because it does not accurately describe the pathophysiology of hypochloremic alkalosis. While it is true that the kidneys play a crucial role in maintaining electrolyte balance, the primary cause of hypochloremic alkalosis is the loss of hydrogen and chloride ions from the body.
* **Option B:** This option is incorrect because it implies that hypochloremic alkalosis is caused by a decrease in potassium levels, which is not the primary cause of this condition.
* **Option C:** This option is incorrect because it does not accurately describe the pathophysiology of hypochloremic alkalosis.
**Clinical Pearl / High-Yield Fact**
A key clinical feature of hypochloremic alkalosis is the presence of hypokalemia, which can occur due to the increased reabsorption of potassium ions by the kidneys in an attempt to compensate for the loss of hydrogen and chloride ions.
**Correct Answer:** D.