A 55-year-old female presents for a routine follow-up. Her basic metabolic panel returns with a serum chloride of 112 mEq/L. The rest of the BMP is within normal limits. Which interpretation is correct?

Question

Accepted Answer

✅ B. Hyperchloremia — above the normal range of 98–106 mEq/L
Normal serum chloride is 98–106 mEq/L. A value of 112 is above this threshold and is classified as hyperchloremia. Common causes include non–anion-gap metabolic acidosis, large-volume normal saline resuscitation, diarrhea, renal tubular acidosis, and dehydration. It often parallels sodium in disorders of water balance.

❌ A. Normal chloride
Normal chloride is 98–106 mEq/L. A value of 112 exceeds this range, so it cannot be labeled normal. A result of 102, for example, would be normal.

❌ C. Hypochloremia
Hypochloremia is defined as chloride <98 mEq/L. This would apply to a patient with prolonged vomiting, NG suctioning, or diuretic-induced metabolic alkalosis — the opposite direction from this patient.

❌ D. Critical hypochloremia
Critical hypochloremia refers to severely low chloride (<80 mEq/L), typically associated with profound metabolic alkalosis. This patient's value is elevated, so this label is incorrect in both direction and severity.

:::tip
Chloride tends to move with sodium. When interpreting a BMP, always check Na, Cl, and HCO3 together to pattern-recognize acid-base disturbances.
:::

Chloride (Cl) — Normal Range & Interpretation

Clinical Context

Quick Reference

Causes of Elevation

Causes of Depression

Practice Questions

Related Labs

Sources

Ready to practice?