Which electrolyte disturbance is commonly associated with metabolic alkalosis?

• A. Hyperkalemia
• B. Hypokalemia
• C. Hypercalcemia
• D. Hyponatremia

Answer: (B)

Metabolic alkalosis is often seen with low potassium levels because the body’s compensatory and hormonal responses promote potassium loss and shift potassium out of the extracellular space. When alkalosis develops, hydrogen ions move out of cells to help balance the rising pH, and potassium tends to move into cells to maintain electroneutrality. In addition, volume depletion or conditions that raise aldosterone (such as vomiting or diuretic use) stimulate the kidneys to excrete potassium, further lowering serum potassium. So, hypokalemia (low potassium) is a very common accompaniment to metabolic alkalosis.

Hyperkalemia would be more typical with metabolic acidosis or certain types of tissue breakdown. Calcium levels and sodium levels don’t define this pattern on their own—hyponatremia can occur with various states but isn’t a hallmark of metabolic alkalosis.