<prompt> Metabolic alkalosis is caused byRepeated vomitingDiarrheaDiabetic ketosisAll  <response>: Ans: a Repeated vomitingRef: Vasudevan Sreekumari, 6th edi., Pg. 351METABOLIC ALKALOSISPrimary changeExcess of bicarbonate Bicarbonate level 33 mmolL pH increased 7.42Secondary change Increase in PaC02 compensationCAUSES OF METABOLIC ALKALOSISChloride responsiveProlonged vomiting,Nasogastric suctionChloride resistantMineralocorticoid excessPrimary secondary hyperaldosteronismUpper GI obstructionGlucocorticoid excessBarters syndromeCushings syndrome,Adrenal tumourLoop diuretics - blocks reabsorption of sodium, potassium and chlorideExogenous bases - intravenous bicarbonate, massive blood transfusion, antacids, milk alkali syndrome, and sodium citrate overload. 