Severe vomiting and severe burns are associated with what change in chloride levels?

• A. High chloride
• B. Low chloride
• C. Normal chloride
• D. Variable chloride

Answer: (B)

Chloride levels fall when there are large losses of chloride-containing fluids. Vomiting expels gastric secretions rich in hydrochloric acid, so both hydrogen ions and chloride are lost, leading to hypochloremia and a metabolic alkalosis. In severe burns, there is massive extracellular fluid loss and wound exudate that can also deplete chloride before resuscitation, contributing to a low serum chloride. Together, these conditions commonly produce a lower chloride level, i.e., hypochloremia.