+- USMLE Forum - Largest USMLE Community (https://www.usmleforum.com)
+-- Forum: USMLE Forum (https://www.usmleforum.com/forumdisplay.php?fid=1)
+--- Forum: Step 3 (https://www.usmleforum.com/forumdisplay.php?fid=6)
+--- Thread: Cl Resistant vs Chloride Sensitive M. Alkalosis - ben (/showthread.php?tid=128030)
Cl Resistant vs Chloride Sensitive M. Alkalosis - ben - ArchivalUser - 10-13-2006
Could somone expl this concept.
1. Pls Explain what this means restistance vs sensitive CL M Acidosis. (What is the cause of high or low urinary CL??)
2. Which lab values tell syou if it is Cl resistant or sensitive (serum or urinary Cl levels)
thx
0 - ArchivalUser - 10-13-2006
its metabolic alkalosisi which is cl sesitive and resistant . e.g in vomiting u lose ur HCL , so u have to replace with Nacl( vomiting respond to cl replacement ) urinary cl is >20.
while in hyperaldostetonism urinary cl is >20, , treat it with spiranolactone
- we check chloride in urine
guys correct me if i am wrong
0 - ArchivalUser - 10-13-2006
Ok Pls confrim this to see if i understood this rite
In Cl responsive
1.Vomit
---CL lost in vomit => low Cl levels are sensed in Kidney and that activates ren-ang-aldost, which in turn => incr NaCl reabs. & K/H secrtion =>urinary Cl low.
2.Thiazide diurectics
---inhibt cotransport of Na/CL and again => incr delivery to distal duct plus the hypovolemia cause renin-ang-aldost....=> urinary Cl high
In Cl resistant
1. Barter
--Na/K/Cl cotrans imp absorbt., also loose ca into urine ==> incr delivery again to distal collect ==> activate reni-ang-aldost = > incr NaCl at distal collect duct and excrete K/H
but why is this called resistant, b/c even in Barters we end up reabs NaCl thru aldost activation??
Can u guys confrim??
0 - ArchivalUser - 10-13-2006
lala, anyone have a comment, ajeet maybe you can shed some light