ROSH Gastrointestinal Practice Exam

Hypokalemia is the metabolic abnormality most commonly associated with bulimia nervosa due to vomiting. This condition primarily arises from the loss of potassium that occurs when a person vomits repeatedly. During vomiting, significant amounts of gastric acid and electrolytes, including potassium, are expelled from the body. Potassium is an essential electrolyte that plays a critical role in various bodily functions, including muscle contraction and nerve transmission. When potassium levels fall significantly, it can lead to serious health issues, including cardiac complications, muscular weakness, and fatigue. Therefore, individuals with bulimia nervosa, particularly those engaging in self-induced vomiting, are at high risk of developing hypokalemia as a consequence of their eating disorder. In contrast, other metabolic abnormalities mentioned are less directly connected to the mechanism of vomiting seen in bulimia nervosa. Hyperalbuminemia and hypernatremia do not typically result from the act of vomiting in this context, while metabolic acidosis may occur in other scenarios, such as severe dehydration or renal impairment, but is not the most characteristic finding specifically linked to the vomiting seen in bulimia nervosa.