Causes of Metabolic Alkalosis

CICM fellowship SAQs about this topic are generally of two varieties. Most recent SAQs are short, worth little in terms of marks, and satisfied by the candidate merely identifying the disorder as a metabolic alkalosis, or possibly throwing around a few differentials. Most older SAQs trend to the thoughtfully physician-like answer, asking the candidate to articulate their approach to diagnosis of metabolic alkalosis.

The SAQs have so far consisted of the following:

Owing to the highly successful renal bicarbonate excretion mechanism, metabolic alkalosis cannot continue without some sort of maintenance process.

This table is an abridged version.

For completeness, the initiating and maintenance processes can be expanded upon, and presented in a table where the relevant aetiologies are grouped according to purely academic criteria, i.e. according to which major anion or cation is being affected.

Causes of Metabolic Alkalosis; Organised by Inorganic Ion

If one were inclined towards brutally pragmatic functional classification methods, one might try to separate the causes of metabolic alkalosis into groups according to the results of biochemical investigations and clinical features. Such an attempt would result in a complicated table, which would look something like this:

Causes of Metabolic Alkalosis; Organised by Diagnostic Features
Classification Causes and pathophysiology Literature reference

 

References

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