Metabolic abnormality seen in gastric outlet obstruction is: (A) Hypochloremic, hypokalemic acidosis, (B) Hypochloremic, hypokalemic alkalosis, (C) Hyperchloremic, hypokalemic acidosis, (D) Hypochloremic, hyperkalemic alkalosis
Answer is B. Ans. is 'b' i.e. Hypochloremic, hypokalemic alkalosis Repetitive vomiting leads to hypochloremic, hypokalemic metabolic alkalosis. The urine is alkaline initially but eventually it becomes acidic (paradoxical aciduria)Cause of paradoxical aciduriaInitially 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 starts retaining these ions in exchange of hydrogen ions. Thus the urine becomes acidic and the metabolic alkaline state is further aggravated.