METABOLIC ALKALOSIS Elevated blood PH and icreased blood bicarbonate with or without increased blood Pco2(through hypoventlation) your keys for diagnosis and proper managment of this condition are assesment of blood pressure and estimation of urinary cloride. (urine chloride less than 10 mmole per liter)=chloride responsive metabolic alkalosis; .gastrointestinal losses(vomiting;nasogastric suction;villous adenoma) .After diuretic use .Posthypercapnia. (urine chloride more than 20 mmol per litre)=chloride unresponsive metabolic alkalosis; .Mineralocorticoid excess(primaryhyperaldosteronism;cushing syndrome;Bartters syndrome; exogenous cortico steroid use;etc) .Ongoing diuretic use .Hypokalemia ,hypomagnesemia. Mangement Chloride responsive disorders they are often associated with volume depletion and respond to saline infusion with replacement of potassium(KCL) .Chloride unresponsive disorders there is ongoing loss of CL due to the underlying conditionsdiscussed above .treat those underlying disordes. NB;proper compensation(Paco2 rises by 0.75 mmhg for each 1 mmol/litre rise in Hco3) however Paco2 doesnt exceed 55 mmhg.