USMLE (United States Medical Licensing Examination) Step 1 Practice Exam 2026 - Free USMLE Step 1 Practice Questions and Study Guide

Question: 1 / 400

How does vomiting contribute to metabolic alkalosis?

Increases H+ levels

Causes hyperkalemia

Stimulates bicarbonate production

Leads to chloride retention

Vomiting can lead to metabolic alkalosis by causing the loss of hydrochloric acid (HCl) from the stomach. This loss of HCl results in a decrease in chloride levels in the extracellular fluid. In response to this chloride loss, the kidneys retain chloride and excrete bicarbonate (HCO3-), leading to an increase in the serum bicarbonate concentration. This disturbance in the acid-base balance results in metabolic alkalosis. Therefore, option D is the correct answer as it correctly explains how vomiting contributes to metabolic alkalosis.

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