Question

Severe diarrhea causes --
(A). Metabolic alkalosis due to loss of chloride ions.
(B). Metabolic acidosis due to loss of bicarbonate ions.
(C). Hyperkalemia due to decreased renal excretion.
(D). Respiratory acidosis due to retention of \(\text{CO}_2\).
Choose the correct answer from the options given below:

• A. (A), and (D) only.
• B. (A), (C) and (D) only.
• C. (B), (C) and (D).
• D. (B), and (C) only.

Hint:

Remember:
- Loss of gastric juices (vomiting) \(\rightarrow\) Loss of acid \(\rightarrow\) Alkalosis.
- Loss of intestinal juices (diarrhea) \(\rightarrow\) Loss of base (\(\text{HCO}_3^-\)) \(\rightarrow\) Acidosis.

Answer 1

The Correct Option is D

Step 1: Understanding the Concept:
Diarrhea involves the excessive loss of fluid, electrolytes, and alkaline secretions from the gastrointestinal tract, leading to systemic acid-base and electrolyte imbalances.

Step 2: Detailed Explanation:
- Acid-Base Imbalance (B): Intestinal secretions are highly alkaline because they contain high concentrations of bicarbonate ions (\(\text{HCO}_3^-\)). Severe diarrhea leads to massive loss of these bicarbonate ions, resulting in a systemic bicarbonate deficit, which causes metabolic acidosis (B).
- Potassium Imbalance (C): Diarrheal fluids also contain high amounts of potassium. While direct loss can cause depletion, severe dehydration reduces renal blood flow and glomerular filtration rate (GFR). This decreased renal perfusion leads to reduced potassium excretion by the kidneys, resulting in hyperkalemia (C). Acidosis also causes hydrogen ions to shift into cells, displacing potassium into the extracellular fluid.
- Alkalosis (A) and Respiratory Acidosis (D): These do not occur. Alkalosis is typically caused by vomiting (loss of \(\text{HCl}\)), and respiratory acidosis is caused by hypoventilation.

Step 3: Final Answer:
The correct changes are (B) and (C) only, corresponding to option (D).