BB Metabolic Alkalosis Flashcards
causes of metabolic alkalosis
- contraction alkalosis
- hypokalemia
- diuretics
- vomiting
- hyperaldosteronism
- antacid use
what causes contraction alkalosis
- decreased ECV
result of decreased ECV in contraction alkalosis
- activation of RAAS
result of activation of RAAS in contraction alkalosis
- increased H+ secretion in proximal tubule by AGII
- increased HCO3 reabsorption in the proximal tubule
- increased H+ secretion in collecting duct due to aldosterone
what happens in hypokalemia when K+ decreases in the blood
- shifts K+ out of cells and H+ into cells
- low level of H+ in the plasma which will cause an alkalosis
how can loop and thiazide diuretics cause a metabolic alkalosis?
- volume contraction
- hypokalemia
- increased Na/H2O delivery to distal nephron
increased Na/H2O to distal nephron causes
- K+/H+ secretion
Bartter syndrome is a dysfunction of
similar to
- N/K/2Cl pump in ascending limb of LOH
- loop diuretic
Gitelman syndrome is a dysfunction of
similar to
- Na/Cl transporter in distal tubule
- thiazide diuretic
how does vomiting cause metabolic alkalosis
- loss of volume -> contraction alkalosis
- loss of HCl
- loss of K+
result of loss of HCl in vomiting
- increased production of HCl
- HCO3 generated during production
important sign in vomiting
why
- urinary chloride low
- loss of Cl in gastric secretions
hyperaldosteronism due to
- overproduction of aldosterone
- adrenal hyperplasia
- adrenal adenoma (Conn’s syndrome)
result of hyperaldosteronism
- increased K+/H+ secretion
- hypokalemia
- resistant hypertension
aldosterone escape mechanism
- Na/fluid retention causes hypertension
- increased ANP increases sodium and free water excretion
- returns to normal volume status
