High blood ammonia levels result in

• A. Respiratory acidosis
• B. Metabolic acidosis
• C. Metabolic alkalosis
• D. Respiratory alkalosis

Answer: (B)

When the body experiences metabolic acidosis, the kidneys respond by increasing ammoniagenesis, producing more ammonium (NH4+) from glutamine in the proximal tubule. This NH4+ is excreted in the urine, and in the process, bicarbonate is regenerated back into the bloodstream, helping to buffer the acidosis. If this pathway is upregulated to deal with excess acid, blood ammonia levels can rise as part of the enhanced ammonium production and handling of the acid load. That connection makes metabolic acidosis the best fit for high blood ammonia levels in this context.

The other options describe changes in acid-base balance driven by CO2, not by ammonia production, so they don’t align with the mechanism linking ammonia to acid handling.