This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: Surgery
Metabolic abnormality is seen in large colorectal villous adenoma 
Select and explain. 
A. Hypokalemic metabolic alkalosis, B. Hypokalemic metabolic acidosis, C. Chlorine sensitive metabolic acidosis, D. Chlorine resistant metabolic alkalosis
B: Hypokalemic metabolic acidosis
Answer: B: Hypokalemic metabolic acidosis 
Explanation: Villous adenomas causing profuse watery diarrhoea and hypokalemia is known as the McKittrick Wheelock syndrome after it was first described in 1954.
Metabolic abnormalities seen are hyponatraemia, hypokalaemic, and hypochloraemic metabolic acidosis.
Severe volume loss may cause acute renal failure and cardiovascular collapse.
The mechanism of fluid and electrolyte loss is unclear. Locally released prostaglandin E2 has been suggested as the secretagogue responsible for salt wasting, as has a cyclic AMP.

Treatment:

Reversal of the biochemical derangement is the cornerstone of successful management. Once resuscitated, immediate surgical resection of the tumor, is the treatment of choice.