Q. A 50-year old man with the history of a duodenal ulcer is admitted to a hospital after several days of intermittent vomiting. On physical examination he is well-known to have orthostatic (when he stands up) changes in his blood pressure and pulse, no visible jugular venous distension, and marked reduce in his skin turgor. Laboratory tests reveal the next: turgere=to swell.
serum [Na+] = 138 mmole/L
serum [K+] = 2.4 mmole/L slight low
serum [Cl- ] = 88 mmole/L slight low
serum [HCO3- ] = 40 mmole/L high
arterial pH = 7.52 slight slight high
arterial pCO2 = 50 mm Hg slight high
Urine [Na+] = 38 mmole/L
Urine [K+] = 60 mmole/L
What disorder does this man have?
Gastric secretions normally include about 10mmole/L potassium. How do you account for the low serum potassium in this patient?