2012年7月1日 · Hopefully you can feel that if you had a contraction alkalosis, in order to get them back to normal, there will be an "expansion acidosis". Now youre confusion comes from the fact that you learned in acid base studying, metabolic alkalosis is either Chloride responsive or unresponsive and that you could check a urine chloride to tell the ...

2010年3月7日 · Indeed, if HCO3- excess occurred as a result of volume contraction (like you'd see in loop diuretics), then giving saline to such a patient would result Cl- to be filtered in the urine, which then can be exchanged for HCO3-. This type of metabolic alkalosis is saline responsive, and due to the kidney exchanging Cl- for HCO3-, urine Cl is < 10 ...

2013年11月26日 · Hi metabolic alkalosis can be grouped in 4-5 broad groups. GI H+ loss; Renal H+ loss; H+ shift inside cell; Administration of "HCO3-" and contraction alkalosis; If you lose a big volume of bicarbonate-free fluid and you have a relatively constant amount of extracellular bicarbonate, contraction alkalosis occurs. In CF you loose a solution of ...

2007年3月16日 · In the context of vomiting and resultant volume contraction the mechanism for met alkalosis isn't just losing stomach acid through vomiting. Along with H+ you also lose Chloride (in the form of HCl) when vomiting. volume contaction then of course causes the kidneys to reabsorb Na, and thus water, for volume repletion.

2010年11月7日 · It isn't that HCO3- reabsorption causes contraction alkalosis. Instead, ECF volume contraction causes metabolic alkalosis. 1. ECF volume contraction (dehydration from vomiting, for example) stimulates isosmotic reabsorption in the proximal tubule (because the body wants to increase volume) as well as stimulates HCO3 reabsorption; therefore, the ...

2009年6月10日 · 3. Loss of bicarbonate-poor, chloride-rich extracellular fluid, as observed with thiazide diuretic or loop diuretic therapy or chloride diarrhea, leads to contraction of extracellular fluid volume. Because the original bicarbonate mass is now dissolved in a smaller volume of fluid, an increase in bicarbonate concentration occurs. 4.

2012年8月14日 · (2) When referring to saline-responsive and saline-resistant metabolic alkalosis, this is more or less contraction alkalosis vs non-contraction alkalosis, correct? (3) If you have a patient that comes in with metabolic alkalosis, is the interpretation of urinary chloride lead to a DDx that looks like (a) High - Diuretic misuse

2012年4月5日 · In Conn's, as serum potassium ebbs, the principal cell basolateral Na+/K+-ATPase will begin secreting protons instead of K+, producing acidic urine, despite the alkalosis. This is still "paradoxical." The intercalated cell proton-K+ antiporter is less relevant. The "classic" paradoxical aciduria is seen with contraction alkalosis (e.g. vomiting).

2010年12月1日 · The other big thing driving contraction alkalosis is AT2 promoting Na+/H+ exchange in the proximal tubule, which leads to more bicarb reabsorption. I only mention this because for the longest time I was confused about the mechanism for contraction alkalosis, some sources say it's Aldo at the CT and others AT2 at the PCT.

2018年6月2日 · Definitely learn as much as you can including NH4+. It has a significance when calculating urine anion gap and which is important for non-anion gap metabolic acidosis. Also what the kidneys do for H+/HCO3 excess, contraction alkalosis, and calcium/magnesium stuff are reletively new and important as well as hormones like PTH, Aldosterone, and ADH.