Fluid & Electrolyte Q 82 - Gyan Darpan : Learning Portal
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Monday, 28 March 2022

Fluid & Electrolyte Q 82

When chloride concentration drops below 95 mEq/L, reabsorption of which of the following electrolytes increases proportionally?
    A. Hydrogen
    B. Potassium
    C. Sodium
    D. Bicarbonate

Correct Answer: D. Bicarbonate

When chloride concentrations drop below 95 mEq/L, bicarbonate reabsorption increases proportionally, causing metabolic alkalosis. Other choices are cations, chloride is an anion; a cation must always exchange for a cation in order to maintain electrical neutrality.

Option A: Hydrogen is used within the kidneys as an antiporter energy gradient to retain a multitude of other elements. Of interest here, sodium is reabsorbed through an exchange for hydrogen in the renal collecting ducts under the influence of aldosterone.
Option B: Anytime that hydrogen ions are shifted intracellularly, this imbalance in the buffer system has a relative increase in bicarbonate. Processes that drive hydrogen intracellularly include hypokalemia.
Option C: Severe vomiting may lead to the most disproportionate loss of chloride compared to sodium since gastric chloride content is greater than 100 mEq/L and gastric sodium content is relatively low (20 to 30 mEq/L). In individuals with protracted vomiting or nasogastric suction, the serum sodium concentration may be only mildly depressed (130 mEq/L), whereas the serum chloride concentration is usually markedly lowered (80 to 90 mEq/L).

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