Deck 3: The Cellular Environment
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Deck 3: The Cellular Environment
1
How does syndrome of inappropriate antidiuretic hormone (SIADH)cause excess water?
A) The increase in antidiuretic hormone causes retention of sodium that retains excessive water in the renal tubules.
B) The decrease in antidiuretic hormone increases serum glucose,which binds to water.
C) The decrease in antidiuretic hormone prevents the renal tubules from reabsorbing water.
D) The increase in antidiuretic hormone causes retention of water in the renal tubules.
A) The increase in antidiuretic hormone causes retention of sodium that retains excessive water in the renal tubules.
B) The decrease in antidiuretic hormone increases serum glucose,which binds to water.
C) The decrease in antidiuretic hormone prevents the renal tubules from reabsorbing water.
D) The increase in antidiuretic hormone causes retention of water in the renal tubules.
The increase in antidiuretic hormone causes retention of water in the renal tubules.
2
At the arterial end of capillaries,why does fluid move from the intravascular space into the interstitial space?
A) Because the interstitial hydrostatic pressure is higher than the capillary hydrostatic pressure
B) Because the capillary hydrostatic pressure is higher than the capillary oncotic pressure
C) Because the interstitial oncotic pressure is higher than the interstitial hydrostatic pressure
D) Because the capillary oncotic pressure is lower than the interstitial hydrostatic pressure
A) Because the interstitial hydrostatic pressure is higher than the capillary hydrostatic pressure
B) Because the capillary hydrostatic pressure is higher than the capillary oncotic pressure
C) Because the interstitial oncotic pressure is higher than the interstitial hydrostatic pressure
D) Because the capillary oncotic pressure is lower than the interstitial hydrostatic pressure
Because the capillary hydrostatic pressure is higher than the capillary oncotic pressure
3
Infants have the highest overall percentage of body water.
True
4
The two main intracellular fluid compartments are the interstitial fluid contained in the nucleus and the intravascular fluid contained in the cell body.
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5
Why are infants susceptible to significant losses in total body water (TBW)?
A) Because more than half of an infant's body weight is water
B) Because infants have a slow metabolic rate
C) Because infant's kidneys are not mature enough to counter fluids losses
D) Because they are unable communicate adequately when they are thirsty
A) Because more than half of an infant's body weight is water
B) Because infants have a slow metabolic rate
C) Because infant's kidneys are not mature enough to counter fluids losses
D) Because they are unable communicate adequately when they are thirsty
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6
What causes the clinical manifestations of confusion,convulsions,cerebral hemorrhage,and coma in hypernatremia?
A) The high sodium in the blood vessels pulls water out of brain cells into the blood vessels causing brain cells to shrink.
B) The high sodium in the brain cells pulls water out of blood vessels into the brain cells causing them to swell.
C) The high sodium in the blood vessels pulls potassium out of brain cells,which slows the synapses within the brain.
D) The high sodium in the blood vessels draws chloride into the brain cells followed by water causing brain cells to swell.
A) The high sodium in the blood vessels pulls water out of brain cells into the blood vessels causing brain cells to shrink.
B) The high sodium in the brain cells pulls water out of blood vessels into the brain cells causing them to swell.
C) The high sodium in the blood vessels pulls potassium out of brain cells,which slows the synapses within the brain.
D) The high sodium in the blood vessels draws chloride into the brain cells followed by water causing brain cells to swell.
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7
Retention of sodium and water is a cause of edema because of an increase in which pressure?
A) Capillary hydrostatic pressure
B) Interstitial hydrostatic pressure
C) Capillary oncotic pressure
D) Interstitial oncotic pressure
A) Capillary hydrostatic pressure
B) Interstitial hydrostatic pressure
C) Capillary oncotic pressure
D) Interstitial oncotic pressure
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8
Movement of water from the intracellular fluid (ICF)to the extracellular fluid (ECF)is primarily accomplished by active transport.
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9
How is insulin used to treat hyperkalemia?
A) Insulin stimulates sodium to be removed from the cell in exchange for potassium.
B) Insulin binds to potassium to remove it through the kidneys.
C) Insulin transports potassium from the blood to the cell along with glucose.
D) Insulin breaks down the chemical components of potassium so that it is not longer effective.
A) Insulin stimulates sodium to be removed from the cell in exchange for potassium.
B) Insulin binds to potassium to remove it through the kidneys.
C) Insulin transports potassium from the blood to the cell along with glucose.
D) Insulin breaks down the chemical components of potassium so that it is not longer effective.
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10
What is a major determinant of the resting membrane potential necessary for transmission of nerve impulses?
A) The ratio between intracellular sodium (Na+)and extracellular sodium
B) The ratio between intracellular potassium (K+)and extracellular potassium
C) The ratio between intracellular sodium (Na+)and extracellular potassium (K+)
D) The ratio between intracellular potassium (K+)and extracellular sodium (Na+)
A) The ratio between intracellular sodium (Na+)and extracellular sodium
B) The ratio between intracellular potassium (K+)and extracellular potassium
C) The ratio between intracellular sodium (Na+)and extracellular potassium (K+)
D) The ratio between intracellular potassium (K+)and extracellular sodium (Na+)
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11
Insulin and glucose can be given to correct hyperkalemia.
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12
Both loss of sodium and gain of water can cause hyponatremia.
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13
Hyperaldosteronism causes which fluid and electrolyte imbalances?
A) Hyperkalemia,hypernatremia,and fluid volume excess
B) Hypokalemia,hypernatremia,and fluid volume excess
C) Hyperkalemia,hyponatremia,and fluid volume deficit
D) Hypokalemia,hypernatremia,and fluid volume deficit
A) Hyperkalemia,hypernatremia,and fluid volume excess
B) Hypokalemia,hypernatremia,and fluid volume excess
C) Hyperkalemia,hyponatremia,and fluid volume deficit
D) Hypokalemia,hypernatremia,and fluid volume deficit
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14
Why are obese people at greater risk for dehydration than lean people?
A) Because adipose cells contain little water;fat is water repelling
B) Because the metabolic rate of obese adults is slower than lean adults
C) Because the rate of urine output of obese adults is higher than lean adults
D) Because the thirst receptors of the hypothalamus do not function effectively
A) Because adipose cells contain little water;fat is water repelling
B) Because the metabolic rate of obese adults is slower than lean adults
C) Because the rate of urine output of obese adults is higher than lean adults
D) Because the thirst receptors of the hypothalamus do not function effectively
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15
How does the body reestablish equilibrium when solute is added to extracellular fluid making it hypertonic?
A) Water is drawn from the extracellular space to the intracellular space.
B) Sodium is drawn from the extracellular space to the intracellular space.
C) Sodium is drawn from the intracellular space to the extracellular space.
D) Water is drawn from the intracellular space to the extracellular space.
A) Water is drawn from the extracellular space to the intracellular space.
B) Sodium is drawn from the extracellular space to the intracellular space.
C) Sodium is drawn from the intracellular space to the extracellular space.
D) Water is drawn from the intracellular space to the extracellular space.
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16
What mechanisms cause hypernatremia?
A) Syndrome of inappropriate antidiuretic hormone (SIADH)
B) Cushing's disease and hyperaldosteronism
C) Prolonged vomiting or diarrhea
D) Excessive diuretic therapy
A) Syndrome of inappropriate antidiuretic hormone (SIADH)
B) Cushing's disease and hyperaldosteronism
C) Prolonged vomiting or diarrhea
D) Excessive diuretic therapy
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17
Low plasma albumin causes edema as a result of a reduction in which pressure?
A) Capillary hydrostatic pressure
B) Interstitial hydrostatic pressure
C) Capillary oncotic pressure
D) Interstitial oncotic pressure
A) Capillary hydrostatic pressure
B) Interstitial hydrostatic pressure
C) Capillary oncotic pressure
D) Interstitial oncotic pressure
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18
When buffers,such as carbonic acid-bicarbonate,absorb excessive H+ (acid)or OH- (base),a significant change in the plasma pH results.
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19
Both hypokalemia and hyperkalemia can cause muscle weakness.
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20
Proteins are primarily an intracellular buffer.
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21
Hypermagnesemia is usually caused by:
A) hepatitis.
B) renal failure.
C) trauma to the hypothalamus.
D) pancreatitis.
A) hepatitis.
B) renal failure.
C) trauma to the hypothalamus.
D) pancreatitis.
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22
Water movement between the intracellular fluid compartment and the extracellular compartment is primarily a function of:
A) osmotic forces.
B) plasma oncotic pressure.
C) antidiuretic hormone.
D) hydrostatic forces.
A) osmotic forces.
B) plasma oncotic pressure.
C) antidiuretic hormone.
D) hydrostatic forces.
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23
A patient has a long history of smoking.He has blood studies done because he is very tired,is short of breath,and just does not feel well.His blood gases reveal the following findings: pH,7.3;HCO3 27 mEq/L;CO2,58 mmHg.What is the interpretation of these gases?
A) Respiratory alkalosis
B) Metabolic acidosis
C) Respiratory acidosis
D) Metabolic alkalosis
A) Respiratory alkalosis
B) Metabolic acidosis
C) Respiratory acidosis
D) Metabolic alkalosis
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24
Which of the following buffers works the fastest (in minutes to hours)?
A) Hemoglobin Hb/HHb
B) Bicarbonate/Carbonic acid (HCO3/H2CO3)
C) Phosphate (HPO4/H2PO4)
D) Ammonia (NH3/NH4)
A) Hemoglobin Hb/HHb
B) Bicarbonate/Carbonic acid (HCO3/H2CO3)
C) Phosphate (HPO4/H2PO4)
D) Ammonia (NH3/NH4)
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25
What are causes of hyperkalemia?
A) Hyperparathyroidism and malnutrition
B) Vomiting and diarrhea
C) Renal failure and crush injuries
D) Hyperaldosteronism and Cushing disease
A) Hyperparathyroidism and malnutrition
B) Vomiting and diarrhea
C) Renal failure and crush injuries
D) Hyperaldosteronism and Cushing disease
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26
Which groups are at risk for fluid imbalance?
A) Elderly persons,thin women,and infants
B) Infants,children,and obese persons
C) Thin women,obese persons,and elderly persons
D) Obese persons,elderly persons,and infants
A) Elderly persons,thin women,and infants
B) Infants,children,and obese persons
C) Thin women,obese persons,and elderly persons
D) Obese persons,elderly persons,and infants
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27
What initiates the formation of ammonium (NH4)from ammonia (NH3)in the tubular lumen of the kidney?
A) Arterial pH of 7.25
B) Arterial pH of 7.35
C) Arterial pH of 7.55
D) Arterial pH of 7.65
A) Arterial pH of 7.25
B) Arterial pH of 7.35
C) Arterial pH of 7.55
D) Arterial pH of 7.65
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28
_____ alterations occur when changes in total body water (TBW)are accompanied by proportional changes in electrolytes.
A) Isotonic
B) Hypertonic
C) Hypotonic
D) Normotonic
A) Isotonic
B) Hypertonic
C) Hypotonic
D) Normotonic
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29
Which are indications of dehydration?
A) Decreased hemoglobin and hematocrit
B) Muscle weakness and decreased deep tendon reflexes
C) Tachycardia and weight loss
D) Polyuria and hyperventilation
A) Decreased hemoglobin and hematocrit
B) Muscle weakness and decreased deep tendon reflexes
C) Tachycardia and weight loss
D) Polyuria and hyperventilation
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30
During acidosis,the body compensates for the increase in hydrogen ions in the blood by shifting hydrogen ions into the cell in exchange for which electrolyte?
A) Oxygen
B) Sodium
C) Potassium
D) Magnesium
A) Oxygen
B) Sodium
C) Potassium
D) Magnesium
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31
What is the action of natriuretic peptides?
A) They decrease blood pressure and increase sodium and water excretion.
B) They increase blood pressure and decrease sodium and water excretion.
C) They increase heart rate and decrease potassium excretion
D) They decrease heart rate and increase potassium excretion.
A) They decrease blood pressure and increase sodium and water excretion.
B) They increase blood pressure and decrease sodium and water excretion.
C) They increase heart rate and decrease potassium excretion
D) They decrease heart rate and increase potassium excretion.
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32
In hyperkalemia,cardiac rhythm changes are a direct result of:
A) cardiac cell hypopolarization.
B) cardiac cell hyperexcitability.
C) depression of the sinoatrial (SA)node.
D) cardiac cell repolarization.
A) cardiac cell hypopolarization.
B) cardiac cell hyperexcitability.
C) depression of the sinoatrial (SA)node.
D) cardiac cell repolarization.
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33
Physiologic pH is maintained around 7.4 because bicarbonate (HCO3)and carbonic acid (H2CO3)exist in a ratio of:
A) 20:1.
B) 1:20.
C) 10:2.
D) 10:5.
A) 20:1.
B) 1:20.
C) 10:2.
D) 10:5.
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34
The calcium and phosphate balances are influenced by which three substances?
A) Parathyroid hormone,vasopressin,and vitamin D
B) Parathyroid hormone,calcitonin,and vitamin D
C) Thyroid hormone,vasopressin,and vitamin A
D) Thyroid hormone,calcitonin,and vitamin A
A) Parathyroid hormone,vasopressin,and vitamin D
B) Parathyroid hormone,calcitonin,and vitamin D
C) Thyroid hormone,vasopressin,and vitamin A
D) Thyroid hormone,calcitonin,and vitamin A
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35
Secretion of antidiuretic hormone (ADH)and the perception of thirst are stimulated by a(n):
A) decrease in serum sodium.
B) increase in plasma osmolality.
C) increase in glomerular filtration rate.
D) decrease in osmoreceptor stimulation.
A) decrease in serum sodium.
B) increase in plasma osmolality.
C) increase in glomerular filtration rate.
D) decrease in osmoreceptor stimulation.
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36
What is the significance of deep,rapid breathing (Kussmaul respirations)in metabolic acidosis?
A) It indicates that anxiety,with rapid breathing,is a cause of respiratory acidosis.
B) It indicates the excessive carbon dioxide is exhaled to compensate for metabolic acidosis.
C) It indicates that diabetic ketoacidosis is the cause of the metabolic acidosis.
D) It indicates that more oxygen is necessary to compensate for respiratory acidosis.
A) It indicates that anxiety,with rapid breathing,is a cause of respiratory acidosis.
B) It indicates the excessive carbon dioxide is exhaled to compensate for metabolic acidosis.
C) It indicates that diabetic ketoacidosis is the cause of the metabolic acidosis.
D) It indicates that more oxygen is necessary to compensate for respiratory acidosis.
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37
Which enzyme is secreted by the juxtaglomerular cells of the kidney when circulating blood volume is reduced?
A) Angiotensin I
B) Angiotensin II
C) Aldosterone
D) Renin
A) Angiotensin I
B) Angiotensin II
C) Aldosterone
D) Renin
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38
Excessive use of magnesium- and aluminum-containing laxatives can result in:
A) hypomagnesemiA.
B) hypophosphatemia.
C) hyponatremia.
D) hypokalemia.
A) hypomagnesemiA.
B) hypophosphatemia.
C) hyponatremia.
D) hypokalemia.
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39
Chvostek's sign and Trousseau's sign indicate:
A) hypokalemiA.
B) hyperkalemia.
C) hypocalcemia.
D) hypercalcemia.
A) hypokalemiA.
B) hyperkalemia.
C) hypocalcemia.
D) hypercalcemia.
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40
When thirst is experienced,how are osmoreceptors activated?
A) By an increase in the antidiuretic hormone secreted into the plasma
B) By an increase in aldosterone secreted into the plasma
C) By an increase in the hydrostatic pressure of the plasma
D) By an increase in the osmotic pressure of the plasma
A) By an increase in the antidiuretic hormone secreted into the plasma
B) By an increase in aldosterone secreted into the plasma
C) By an increase in the hydrostatic pressure of the plasma
D) By an increase in the osmotic pressure of the plasma
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41
Match each electrolyte imbalance with its clinical manifestations.
Confusion,irritability,depression,headache,seizures
A)Hyponatremia
B)Hypernatremia
C)Hypercalcemia
D)Hypokalemia
E)Hypomagnesemia
Confusion,irritability,depression,headache,seizures
A)Hyponatremia
B)Hypernatremia
C)Hypercalcemia
D)Hypokalemia
E)Hypomagnesemia
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42
Match each electrolyte imbalance with its clinical manifestations.
Absent bowel sounds,skeletal muscle weakness,bradycardia
A)Hyponatremia
B)Hypernatremia
C)Hypercalcemia
D)Hypokalemia
E)Hypomagnesemia
Absent bowel sounds,skeletal muscle weakness,bradycardia
A)Hyponatremia
B)Hypernatremia
C)Hypercalcemia
D)Hypokalemia
E)Hypomagnesemia
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43
MATCHING
Match the electrolytes with the corresponding descriptions.(Terms can be used more than once. )
Required for glycogen deposition in the liver
A)Sodium
B)Chloride
C)Potassium
D)Magnesium
E)Phosphate
Match the electrolytes with the corresponding descriptions.(Terms can be used more than once. )
Required for glycogen deposition in the liver
A)Sodium
B)Chloride
C)Potassium
D)Magnesium
E)Phosphate
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44
Which are causes of hypocalcemia?
A) Repeated blood administration or pancreatitis
B) Kidney stones and immobility
C) Decreased resorption of calcium and phosphate from bone
D) Hyperparathyroidism and bone metastasis
A) Repeated blood administration or pancreatitis
B) Kidney stones and immobility
C) Decreased resorption of calcium and phosphate from bone
D) Hyperparathyroidism and bone metastasis
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45
How does the loss of chloride during vomiting cause metabolic alkalosis?
A) Loss of chloride stimulates the release of aldosterone,which causes the retained sodium to bind with the chloride.
B) Loss of chloride causes hydrogen to move into the cell and exchange with potassium to maintain cation balance.
C) Loss of chloride causes retention of bicarbonate to maintain the anion balance.
D) Loss of chloride causes hypoventilation to compensate for the metabolic alkalosis.
A) Loss of chloride stimulates the release of aldosterone,which causes the retained sodium to bind with the chloride.
B) Loss of chloride causes hydrogen to move into the cell and exchange with potassium to maintain cation balance.
C) Loss of chloride causes retention of bicarbonate to maintain the anion balance.
D) Loss of chloride causes hypoventilation to compensate for the metabolic alkalosis.
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46
Match each electrolyte imbalance with its clinical manifestations.
Weight gain,bounding pulse,increased blood pressure,edema
A)Hyponatremia
B)Hypernatremia
C)Hypercalcemia
D)Hypokalemia
E)Hypomagnesemia
Weight gain,bounding pulse,increased blood pressure,edema
A)Hyponatremia
B)Hypernatremia
C)Hypercalcemia
D)Hypokalemia
E)Hypomagnesemia
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47
MATCHING
Match the electrolytes with the corresponding descriptions.(Terms can be used more than once. )
Acts as an intracellular and extracellular anion buffer
A)Sodium
B)Chloride
C)Potassium
D)Magnesium
E)Phosphate
Match the electrolytes with the corresponding descriptions.(Terms can be used more than once. )
Acts as an intracellular and extracellular anion buffer
A)Sodium
B)Chloride
C)Potassium
D)Magnesium
E)Phosphate
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48
MATCHING
Match the electrolytes with the corresponding descriptions.(Terms can be used more than once. )
Changes in hydrogen ion concentration affect this electrolyte
A)Sodium
B)Chloride
C)Potassium
D)Magnesium
E)Phosphate
Match the electrolytes with the corresponding descriptions.(Terms can be used more than once. )
Changes in hydrogen ion concentration affect this electrolyte
A)Sodium
B)Chloride
C)Potassium
D)Magnesium
E)Phosphate
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49
MATCHING
Match the electrolytes with the corresponding descriptions.(Terms can be used more than once. )
Regulation of osmolality
A)Sodium
B)Chloride
C)Potassium
D)Magnesium
E)Phosphate
Match the electrolytes with the corresponding descriptions.(Terms can be used more than once. )
Regulation of osmolality
A)Sodium
B)Chloride
C)Potassium
D)Magnesium
E)Phosphate
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50
MATCHING
Match the electrolytes with the corresponding descriptions.(Terms can be used more than once. )
An intracellular metabolic form is ATP
A)Sodium
B)Chloride
C)Potassium
D)Magnesium
E)Phosphate
Match the electrolytes with the corresponding descriptions.(Terms can be used more than once. )
An intracellular metabolic form is ATP
A)Sodium
B)Chloride
C)Potassium
D)Magnesium
E)Phosphate
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51
Match each electrolyte imbalance with its clinical manifestations.
Depression,confusion,irritability,increased reflexes,tetany
A)Hyponatremia
B)Hypernatremia
C)Hypercalcemia
D)Hypokalemia
E)Hypomagnesemia
Depression,confusion,irritability,increased reflexes,tetany
A)Hyponatremia
B)Hypernatremia
C)Hypercalcemia
D)Hypokalemia
E)Hypomagnesemia
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52
MATCHING
Match the electrolytes with the corresponding descriptions.(Terms can be used more than once. )
Major determinant of resting membrane potential
A)Sodium
B)Chloride
C)Potassium
D)Magnesium
E)Phosphate
Match the electrolytes with the corresponding descriptions.(Terms can be used more than once. )
Major determinant of resting membrane potential
A)Sodium
B)Chloride
C)Potassium
D)Magnesium
E)Phosphate
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53
MATCHING
Match the electrolytes with the corresponding descriptions.(Terms can be used more than once. )
Inversely related to HCO3 concentration
A)Sodium
B)Chloride
C)Potassium
D)Magnesium
E)Phosphate
Match the electrolytes with the corresponding descriptions.(Terms can be used more than once. )
Inversely related to HCO3 concentration
A)Sodium
B)Chloride
C)Potassium
D)Magnesium
E)Phosphate
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54
Match each electrolyte imbalance with its clinical manifestations.
Fatigue,weakness,kidney stones,varying degrees of heart block
A)Hyponatremia
B)Hypernatremia
C)Hypercalcemia
D)Hypokalemia
E)Hypomagnesemia
Fatigue,weakness,kidney stones,varying degrees of heart block
A)Hyponatremia
B)Hypernatremia
C)Hypercalcemia
D)Hypokalemia
E)Hypomagnesemia
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