USMLE (United States Medical Licensing Examination) Step 1 Practice Exam

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How does vomiting contribute to metabolic alkalosis?

  1. Increases H+ levels

  2. Causes hyperkalemia

  3. Stimulates bicarbonate production

  4. Leads to chloride retention

The correct answer is: Leads to chloride retention

Vomiting can lead to metabolic alkalosis by causing the loss of hydrochloric acid (HCl) from the stomach. This loss of HCl results in a decrease in chloride levels in the extracellular fluid. In response to this chloride loss, the kidneys retain chloride and excrete bicarbonate (HCO3-), leading to an increase in the serum bicarbonate concentration. This disturbance in the acid-base balance results in metabolic alkalosis. Therefore, option D is the correct answer as it correctly explains how vomiting contributes to metabolic alkalosis.

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