Question

Which of the following lead to the condition of metabolic acidosis?
A. Hyperkalemia
B. Lactic acidosis
C. Ketosis
D. Hypochloremia
Choose the correct answer from the options given below:

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

Hint:

Acidosis and hyperkalemia often occur together because hydrogen ions move into cells during acidosis, forcing potassium ions out into the extracellular fluid to maintain electrical balance.

Answer 1

The Correct Option is A

Step 1: Understanding the Concept:
Metabolic acidosis is a systemic disorder characterized by a primary decrease in bicarbonate (\(HCO_3^-\)) concentration, typically accompanied by a reduction in blood pH.
This can be caused by the accumulation of metabolic acids or an excessive loss of bicarbonate from the body.

Step 2: Detailed Explanation:
Let us analyze each statement:
A. Hyperkalemia: High extracellular potassium levels inhibit renal ammoniagenesis and ammonium excretion.
This impairs the kidney's ability to excrete hydrogen ions, leading to metabolic acidosis. Additionally, transcellular exchange causes potassium to move into cells while hydrogen ions move out into the extracellular fluid.
B. Lactic acidosis: The accumulation of lactic acid, typically due to anaerobic metabolism or tissue hypoperfusion, directly lowers blood pH, causing a high anion gap metabolic acidosis.
C. Ketosis: The accumulation of ketone bodies (such as acetoacetate and \(\beta\)-hydroxybutyrate) in conditions like diabetic ketoacidosis releases hydrogen ions, leading to metabolic acidosis.
D. Hypochloremia: Low levels of chloride ions typically lead to metabolic alkalosis, as the kidneys retain bicarbonate to maintain electrical neutrality in the plasma.
Therefore, Hyperkalemia, Lactic acidosis, and Ketosis are associated with metabolic acidosis, while Hypochloremia is not.

Step 3: Final Answer:
The conditions that lead to metabolic acidosis are Hyperkalemia, Lactic acidosis, and Ketosis (A, B and C only).