Which of the following occur as a result of persistant vomiting?
**Core Concept**
Persistent vomiting leads to the loss of gastric contents, which are rich in hydrochloric acid (HCl). This results in a decrease in chloride ions (Cl-) in the body, causing hypochloremia. The loss of HCl also leads to metabolic alkalosis, as the body compensates by increasing bicarbonate levels.
**Why the Correct Answer is Right**
Hypochloremia occurs due to the loss of chloride ions in the gastric contents that are vomited. This results in a decrease in the chloride ion concentration in the blood, leading to hypochloremia. The body attempts to compensate for the loss of HCl by increasing renal reabsorption of bicarbonate, which further exacerbates the metabolic alkalosis.
**Why Each Wrong Option is Incorrect**
* **Option A:** Hyperkalemia is not a direct result of persistent vomiting. Vomiting leads to the loss of potassium ions, but the body also compensates by increasing renal potassium excretion, which can lead to hypokalemia.
* **Option C:** Hyperventilation is a compensatory mechanism for metabolic alkalosis, not a direct result of persistent vomiting. As the body attempts to compensate for the increased bicarbonate levels, it leads to hyperventilation.
* **Option D:** Acidic urine excretion is not a result of persistent vomiting. In fact, the kidneys excrete more bicarbonate ions in the urine to compensate for the metabolic alkalosis, leading to alkaline urine excretion.
**Clinical Pearl / High-Yield Fact**
Remember the "chloride shift" in metabolic alkalosis: the loss of chloride ions in the gastric contents leads to hypochloremia, which in turn causes the kidneys to increase bicarbonate reabsorption, exacerbating the metabolic alkalosis.
**✓ Correct Answer: B. Hypochloremia**