Sutures and Wound Repair/ General Surgery (ABSA) Practice Test

What follows after alkalosis due to loss of hydrochloric acid in SBO?

1. Hypertensive crisis

2. Metabolic acidosis

3. Cardiac arrest

4. Hyperglycemia

The correct answer is: Metabolic acidosis

The correct answer is metabolic acidosis, which typically follows alkalosis due to loss of hydrochloric acid in conditions like small bowel obstruction (SBO). When hydrochloric acid, which is rich in hydrogen ions, is lost—such as through prolonged vomiting or gastric drainage—it leads to a state of alkalosis because the body is depleted of acid. However, as the condition progresses, especially in the context of an SBO, there can be a decrease in blood flow and oxygen delivery to the tissues, leading to cellular metabolic processes generating acids (like lactic acid) as a byproduct. This accumulation of acids, alongside the initial state of alkalosis, ultimately results in a compensatory metabolic acidosis, where the body attempts to correct the pH balance by increasing the production and retention of acids. Understanding this physiological adaptation helps in recognizing how the body transitions states based on the underlying metabolic changes, particularly in critical care and surgical scenarios.