Deck 1: Electrolyte Imbalances and Acid-Base Disorders

Question 1

Which is incorrect with regards to the fluid and its content?

A)Normal Saline - 150mmol Na+/L
B)Hartmans - 131mmol Na+/L
C)Hartmans -131mmolCl-/L
D)D5W- 50gm glucose/L
E)Hartmans- 5 mmol K+/L

Answer 1

Hartmans -131mmolCl-/L

Question 2

Which is not a possibility in the ECG of a pt with hypokalemia?

A)prolong PR interval
B)prominent U waves
C)T wave flattening
D)Prolonged QT interval
E)T wave inversion in praecordial leads

Answer 2

Prolonged QT interval

Question 3

Which is not a cause of hypokalemia?

A)insulin administration
B)adrenaline infusion
C)alkalosis
D)toluene toxicity
E)digoxin OD

Answer 3

digoxin OD

Question 4

Which of the drugs below are not associated with hypokalemia?

A)loop diuretics
B)corticosteroids
C)gentamicin
D)amiloride
E)theophylline

Question 5

Which contains the largest amount of K+?

A)two Slow K tablets
B)2 chlorvescent tablets
C)15ml of Kayciel
D)one gram iintravenous KCL
E)a banana

Question 6

A rise in the pH by 0.1 causes what decrease in serum K+?

A)0.1 mEq/L
B)0.25 mEq/L
C)0.5mEq/L
D)0.7mEq/L
E)1.0mEq/L

Question 7

Which does not shift K+ into cells?

A)insulin
B)dextrose
C)NaHCO3
D)Salbutamol
E)resonium

Question 8

What is seen earliest in an ECG of hyperkalemia?

A)Sine wave
B)Peak T wave
C)Flattened p wave
D)QRS widening
E)AV disocciation

Question 9

To diagnose SIADH as the cause of hyponatremia which must not be present?

A)hypovolemia
B)hypotonicity
C)no cardiac/renal/ hepatic failure
D)urine osmolality >100ml/kg
E)urinary Na >20 mmol/ml

Question 10

which statement is incorrect?

A)hyperlipidaemia can cause an artificially low Na+
B)if the hyponatremia is known to be of less than 48 hours duration it can be corrected quickly
C)in chronic hyponatremia, the Na+ should not be raised by more than 0.5mmol/l/hr
D)if the Na+ level is raised too quickly in a pt with chronic hyponatremia it vauses an increase in ICP
E)central pontine myelinolysis is caused when hypernatremia is corrected to quickly

Question 11

Which neoplasm is not characteristically associated with SIADH?

A)mesothelioma
B)bronchogenic carcinoma
C)breast
D)prostate
E)bladder

Question 12

Which drug is not well known to cause hyponatremia?

A)sertraline
B)amitryptilline
C)ecstasy
D)carbamazepine
E)roxithromycin

Question 13

With regards to hypernatremia which is incorrect?

A)it should not be corrected greater than 0.5mmol/L/hr
B)is usually associated with inadequate water intake
C)Normal Saline should not be used if the pt is hypovolemic and hypotensive
D)If associated with hypervolemia then frusemide should be used
E)It is clinically manifest by primarily neurological effects

Question 14

w.th regards to Calcium which statement is incorrect?

A)the normal correct range is 2.1-2.5
B)the ionized correct range is 1.14-1.3
C)to correct for the low albumin add 0.1 to the total calcium for every 4 the albumin is below 36
D)the ionized calcium increases by 0.05 for every 0.1 drop in pH
E)calcium chloride has less elememtal calcium than calcium gluconate

Question 15

What is not a cause of hypercalcemia?

A)post prandial measurement
B)tuberculosis
C)lung Ca
D)hypomagnasemia
E)renal failure

Question 16

Which is incorrect with regards to hypocalcemia?

A)it causes QT prolongation
B)treatment with calcium may not work if magnesium is not given as well
C)i.v administation of calcium requires cardiac monitoring
D)it is seen in pancreatitis
E)hyperventilation produces tetany by causes a fall in the total body calcium

Question 17

Which is not true of hypomagnasemia?

A)it increases SA node automaticity
B)it causes pre eclampsia
C)it prolongs the QT increasing the risk of Toursades
D)it is associated with a 2-3 times increased risk of AF and SVT post AMI
E)symptoms include weakness, lethargy, and poorly controlled AF despite adequate digoxin

Question 18

Which is not true with regards to hypermagnesemia?

A)it is nearly always seen in renal failure
B)it causes nausea, vomiting, loss of deep tendon reflexes, drowsiness and hypotension
C)it causes hypocalcemia
D)if an overdose is taken, Calcium should be given as it is direct antagonist of magnesium
E)it causes widening of the QRS

Question 19

Which equation is incorrect?

A)anion gap =(Na+ + K+) - (Cl- + HCO??)
B)calculated serum osmolality = 2(Na + urea +glucose)
C)paO? = pIO? - paCO?/0.8
D)the expected CO? in metabolic acidosis = 1.5 × HCO?? + 8
E)the expected CO? in metabolic alkalosis =0.9× HCO?? + 9

Question 20

Which statement is incorrect?

A)the normal Aa gradient is B)in respiratory alkalosis, for every drop of 10mmHg of pCO2, the HCO3- drops 1 mmol/L acutely
C)in chronic respiratory alkalosis, for every drop of 10mmHg of pCO2, the HCO3- drops 2mmol/L
D)in acute respiratory acidosis, for every 10mmHg rise in pCO2 ,the HCO3 rises 1mmol/L
E)in chronic respiratory acidosis, for every 10mmHg rise in pCO2 ,the HCO3 rises 2mmol/L

Question 21

which does not cause a high osmolar gap, increased anion gap metabolic acidosis?

A)methanol
B)ethanol
C)ethylene glycol
D)acetone
E)chloral hydrate

Question 22

Which agent below does no cause an increased anion gap metabolic acidosis?

A)acetzolamide
B)paraldehyde
C)iron
D)aspirin
E)carbon monoxide inhalation

Question 23

Which condition can be fully compensated for with regards to pH?

A)respiratory acidosis
B)respiratory alkalosis
C)metabolic acidosis
D)metabolic alkalosis
E)none of the above

Question 24

Which does not cause a metabolic alkalosis?

A)vomiting
B)diarrohea
C)loop diuretics
D)thiazide diuretics
E)corticosteroids