Question 1

Which does not shift K+ into cells?

Accepted Answer

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

Question 2

Which contains the largest amount of K+?

Accepted Answer

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

Question 3

Which is not true with regards to hypermagnesemia?

Accepted Answer

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 C

Question 4

What is not a cause of hypercalcemia?

Accepted Answer

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

Question 5

Which is not a cause of hypokalemia?

Accepted Answer

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

Question 6

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

Accepted Answer

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

Question 7

Which equation is incorrect?

Accepted Answer

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 8

w.th regards to Calcium which statement is incorrect?

Accepted Answer

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 9

Which is not true of hypomagnasemia?

Accepted Answer

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 10

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

Accepted Answer

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

Question 11

Which does not cause a metabolic alkalosis?

Accepted Answer

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

Question 12

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

Accepted Answer

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

Question 13

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

Accepted Answer

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

Question 14

Which statement is incorrect?

Accepted Answer

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 15

Which neoplasm is not characteristically associated with SIADH?

Accepted Answer

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

Question 16

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

Accepted Answer

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

Question 17

Which drug is not well known to cause hyponatremia?

Accepted Answer

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

Question 18

Which of the drugs below are not associated with hypokalemia?

Accepted Answer

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

Question 19

What is seen earliest in an ECG of hyperkalemia?

Accepted Answer

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

Question 20

With regards to hypernatremia which is incorrect?

Accepted Answer

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

Exam 1: Electrolyte Imbalances and Acid-Base Disorders