In metabolic alkalosis with low volume, which treatment is suggested by the material?

• A. Potassium Chloride
• B. Sodium Bicarbonate
• C. Hypertonic Saline
• D. Isotonic Saline

Answer: (B)

The main idea here is that contraction metabolic alkalosis with low volume is driven by fluid and electrolyte losses that promote bicarbonate retention. The priority is to restore circulating volume and supply chloride so the kidneys can excrete the excess bicarbonate. Replenishing with isotonic saline provides both sodium and chloride, expands the intravascular volume, and helps suppress the mechanisms (like the renin–angiotensin–aldosterone system) that drive bicarbonate retention. If potassium is low, repletion with potassium (often as potassium chloride) is important because hypokalemia sustains alkalosis by promoting bicarbonate reabsorption.

Sodium bicarbonate would add buffering capacity and raise bicarbonate levels further, which worsens alkalosis, so it is not the typical choice in straightforward contraction alkalosis. Hypertonic saline is not the standard initial therapy for this scenario unless there are other complicating factors (like severe hyponatremia or brain injury). Potassium chloride helps correct electrolyte deficits but does not address the volume issue by itself.