Exam 25: The Body Fluid Compartments: Extracellular and Intracellular Fluids; Edema

A 70 kg patient needs fluid therapy. You decide to administer 2.0 liters of 5% glucose solution (isoosmotic) by intravenous infusion. After osmotic equilibrium and metabolism of the glucose, which of the following changes would you expect?

Which of the following would tend to cause hyperkalemia by shifting potassium from the intracellular fluid into the extracellular fluid?

In the patient described in question 31, which of the following laboratory values are you likely to find compared with normal?

Which of the following changes would you expect to find in a patient with Liddle's syndrome under steady-state conditions, assuming that intake of electrolytes remained constant?

Following Questions : Choose the appropriate nephron site in the diagram for each question. -In a patient with severe "central" diabetes insipidus caused by lack of antidiuretic hormone secretion, which part of the tubule would have the lowest tubular fluid osmolarity?

A patient with uncontrolled type 2 diabetes and a plasma glucose concentration of 400 mg/100 ml (normal, ~100 mg/100 ml), and with normal lungs.

Renal tubular acidosis is associated with____ plasma pH, renal HCO3^- excretion, and renal NH4⁺ excretion. a. Increased, increased, increased b. Decreased, decreased, decreased c. Decreased, increased, decreased d. Decreased, decreased, increased e. Decreased, increased, increased

The diagrams below represent various states of abnormal hydration. In each diagram, the normal state (solid lines) is superimposed on the abnormal state (dashed lines) to illustrate the shifts in the volume (width of rectangles) and total osmolarity (height of rectangles) of the extracellular fluid and intracellular fluid compartments. -Which of the diagrams would represent the changes (after osmotic equilibrium) in a patient with inappropriate excess antidiuretic hormone secretion?

Which of the following changes would you expect to find after administration of a vasodilator that selectively reduced afferent arteriolar resistance?

You begin treatment of a hypertensive patient with a large dose of a powerful diuretic (Lasix) that inhibits tubular reabsorption of NaCl by the loop of Henle. He returns to your office for a follow-up examination 2 weeks later. Compared with the patient's status before treatment, which one of the following sets of conditions would you expect to find?

Which part of the nephron normally reabsorbs the most urea?

A 60-year-old female patient appears to be dehydrated, with a hematocrit of 0.55 (55%) and a plasma protein concentration of 8.8 g percent (normal, ~7.0). After obtaining a plasma sample, you find that she has hyponatremia, with a plasma sodium concentration of 110 mmol/L and a plasma osmolarity of 240 mOsm/L. You decide to administer 2.0 L of 3% sodium chloride. Her body weight was 80 kg before giving the fluid. Assume the following:· Intracellular fluid volume = 40% of body weight before fluid administration · Extracellular fluid volume = 20% of body weight before fluid administration · Molecular weight of NaCl = 58.5 g/mol · No excretion of water or electrolytes Calculate her approximate plasma osmolarity after administration of the NaCl solution and after osmotic equilibrium.

The diagrams represent various states of abnormal hydration. In each diagram, the normal state (solid lines) is superimposed on the abnormal state (dashed lines) to illustrate the shifts in the volumes (width of rectangles) and total osmolarities (height of rectangles) of the extracellular fluid and intracellular fluid compartments. -A 22-year-old man runs a 10 km race on a 90 °F day. If he loses 3 liters of sweat and also drinks 3 liters of water during the race, which of the following changes would you expect, compared with normal, after absorption of the water? Intracellular Intracellular Extracellular Extracellular Volume Osmolarity Volume Osmolarity A. \uparrow \uparrow \uparrow \uparrow B. \uparrow \downarrow \downarrow \downarrow C. \leftrightarrow \downarrow \leftrightarrow \leftrightarrow D. \downarrow \uparrow \uparrow \uparrow E. \downarrow \downarrow \downarrow \downarrow

A patient has the following laboratory values: - Arterial $\mathrm { pH } = 7.55$ - Plasma $\mathrm { HCO } _ { 3 } { } ^ { - } = 40 \mathrm { mEq } / \mathrm { L }$ - Plasma chloride concentration $= 101 \mathrm { mE } \mathrm { q } / \mathrm { L }$ - Arterial $\mathrm { pCO } _ { 2 } = 48 \mathrm {~mm} \mathrm { Hg }$ - Plasma sodium $= 150 \mathrm { mEq } / \mathrm { L }$ What is the most likely cause for his abnormal acid-base status?

Which of the following changes, compared with normal, would you expect to find in a patient with metabolic acidosis caused by uncontrolled diabetes mellitus?

Evaluation of kidney function in a 46-year-old obese man with type 2 diabetes reveals the following: · Urine volume = 5760 mL of urine, collected over the preceding 24 hours · Plasma creatinine = 3 mg/100 mL · Urine creatinine = 30 mg/100 mL · Plasma potassium = 4.0 mmol/L · Urine potassium = 20 mmol/L What is his approximate glomerular filtration rate, assuming that he collected all of his urine in the 24-hour period?

You are monitoring a patient in your nephrology clinic whose serum creatinine concentration has risen from 1.0 to 4.0 mg/dL over a period of 5 years. Which of the following additional changes, compared with normal, would you expect to find in this patient? Assume steady-state conditions and that he has maintained the same diet.

If the tubular fluid/plasma creatinine concentration ratio in the collecting duct is 100, what is the approximate percentage of the filtered water that remains at that point?

Which of the following would cause the greatest degree of hypokalemia?

A 22-year-old female patient complaining of headaches presents to your office. An examination reveals that her blood pressure is 180/118 mm Hg, and laboratory tests give the following results: · Plasma renin activity = 14.5 (normal = 1.0) · Plasma Na⁺ = 142 mmol/L · Plasma K⁺ = 2.9 mmol/L Magnetic resonance imaging of the kidneys suggests that she has a renin-secreting tumor in her left kidney. Compared with normal, which one of the following sets of conditions would you expect?