adrenal insufficiency pt - quansar

[ArchivalUser]

in addison's disease, blood analysis you will see Na, Cl, and HCO3 level:

1. down, down, down
2. down, up, down
3. down, down, up
4. down, no change, down
5. down, down, no change

answer and why?

[ArchivalUser]

Na and HCO3 level decrease, since K is increased I assume cl is also is up.
2. down, up, down

I will explain only if my answer is correct, thank you and let see more input I hope.

This is very good question, All I know is Normal AG metabolic acidosis with Addison's desease.
))

[ArchivalUser]

down, down down

[ArchivalUser]

can you explain why CL is down please

[ArchivalUser]

saonew, I made the same mistake as you do.

apprantly in addison's disease, you will get low Na and Low HCO3. and since it will be metablic acidosis, I assume it will most likely normal anion gap acidosis therefore Cl will increase to compensate the lowered HCO3.

but dolly123 got the answer correct, cl is also down.

that means in addison's disease, we are getting the increased anion gap metaolic acidosis.

I could not figure it why it happened though

[ArchivalUser]

I tried to see how chloride go down and I think I was cofused.

According to Papi: Hypoaldosteronism leads to loss of function of aldosterone-enhanced distal Na and H+ pumps and retention of K+.

From another source: chloride follows sodiums losses and accompagnies sodium excess to maintain electrical neurality.

decreased level of chloride is asso with Addisson's desease.

Thank you for this one .

[ArchivalUser]

i am afraid my approach was very unscientific...i did no reasoning,
I just chose the values that were opposite to what they are in hyperaldosteroinsm, which i understand much better ....

[ArchivalUser]

lack of aldesterone secretion decreases renal tubular Na reabsortion and consequently allows Sodium iones, chloride ions and water to be lost in to urine in great profusion.
the net result is a greatly decreased extracellular fluid volume.
and futhermore to hyponatremia , hyperkaliemia and acidosis develop, because of failure of potassium and hydrogen ions to be secreted in exchange for sodium reabsorbtion