A 50-year old man with a history of a duodenal ulcer is admitted to the hospital after several days of intermittent vomiting. On physical examination he is noted to have orthostatic ( when he stands up) changes in his blood pressure and pulse, no visible jugular venous distension, and marked decrease in his skin turgor. Laboratory tests reveal the following: 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 contain about 10mmole/L potassium. How do you account for the low serum potassium in this patient?