fluid

Question 1

1. Tonicity of the plasma is increased by:
Select one or more:
a. urea
b. K+
c. glucose (in untreated DM)
d. Na+

Answer 1

a/b/c/d

Question 2

2. It is a colloid solution:
Select one:
a. Lactated Ringer (Hartmann’s)
b. dextran
c. 0.9% NaCl
d. 5% glucose
e. Ringer

Answer 2

b

Question 3

3. Which route is the most significant for Na+ excretion?
Select one:
a. respiration
b. urine
c. sweating
d. stool
e. squamous cells

Answer 3

b

Question 4

4. It may be a symptom of hypernatremia:
Select one or more:
a. fever
b. nausea, vomiting
c. spasticity
d. irritability

Answer 4

a/b/c/d

Question 5

5. The most common cause of hypernatremia:
Select one:
a. excessive intake of sodium
b. Cushing’s syndrome
c. overdose of diuretics
d. Conn’s syndrome
e. restricted water intake

Answer 5

d

Question 6

Must be excluded for the diagnosis of SIADH:
Select one or more:
a. osmotic diuresis
b. hypothyroidism
c. diarrhea
d. Addison’s disease

Answer 6

b/d

Question 7

7. The average volume of the interstitial space in men:
Select one:
a. 5 l
b. 8 l
c. 12 l
d. 20 l
e. 25

Answer 7

c

Question 8

8. Cca. how much 5% glucose solution must be infused to increase the blood volume by 1 liter?
Select one:
a. 1–2 liters
b. 2–4 liters
c. 4–6 liters
d. 6–8 liters
e. 10–14 liters

Answer 8

e

Question 9

9. Above which value is considered hypernatremia severe?
Select one:
a. 140 mmol/l
b. 145 mmol/l
c. 150 mmol/l
d. 155 mmol/l
e. 160 mmol/l

Answer 9

d

Question 10

10. Which ion concentration is the highest in the EC space?
Select one:
a. H+
b. Mg++
c. Cl–
d. K+
E. Ca++

Answer 10

c

Question 11

11. The average daily Na+ intake is:
Select one:
a. 5 mmol
b. 20 mmol
c. 80 mmol
d. 120 mmol
e. 200 mmol

Answer 11

d

Question 12

12. The infusion of which solution produces the largest increase of blood volume?
Select one:
a. Ringer
b. 0.9 % NaCl
c. 5% glucose
d. 5 % albumin
e. Lactated Ringer (Hartmann’s)

Answer 12

d

Question 13

13. Water poisoning may occur in:
Select one or more:
a. schizophrenia
b. ketosis
c. Cushing’s syndrome
d. marathon runners

Answer 13

a/d

Question 14

14. Which of the following are idiogenic osmoles?
Select one or more:
a. taurine
b. Cl–
c. glycine
d. Na+

Answer 14

a

Question 15

15. Disadvantages of colloid solutions in volume therapy, except:
Select one:
a. they may cause kidney injury
b. they may cause coagulopathy
c. they cause interstitial edema
d. they are more expensive
e. they may cause anaphylactic reaction

Answer 15

c

Question 16

16. Who are more likely to have a fatal outcome in case of water poisoning?
Select one or more:
a. women
b. children
c. alcoholics
d. elderly people

Answer 16

a/b

Question 17

17. The dynamic changes in water excretion by the kidneys occur in order to stabilize:
Select one:
a. the cell volumes
b. the potassium level of the plasma
c. the osmolarity of the blood
d. the total protein level of the plasma
e. the glucose level of the blood

Answer 17

a/c

Question 18

18. Possible symptoms of hyponatremia, except:
Select one:
a. nausea, vomiting
b. headache
c. abdominal pain
d. intense thirst
e. confusion

Answer 18

d

Question 19

19. Which statement is true for normal saline?
    Select one or more:
    a. it has equal tonicity to the plasma
    b. it gets excreted faster than lactated Ringer
    c. it does not cause any change in the acid-base balance
    d. it is recommended for resuscitation

Answer 19

a

Question 20

20. Which is the proper treatment of hyponatremia?
Select one:
a. V2 receptor antagonist
b. restricting water intake
c. mineralocorticoids
d. infusing normal saline
e. insulin

Answer 20

d

Question 21

21. SIADH may be caused by:
Select one or more:
a. mutation of the gene of the V2 receptor
b. malignant tumor
c. drug effect
d. CNS lesions

Answer 21

b/c/d

Question 22

22. AVP production is stimulated by:
Select one or more:
a. MDMA (extasy)
b. hypotension
c. CNS lesions
d. excessive physical activity

Answer 22

a/b/c

Question 23

23. It is true for the central form of diabetes insipidus:
    Select one or more:
    a. 50% of the cases are idiopathic
    b. it responds well to V2 receptor antagonists
    c. nycturia
    d. plasma osmolarity is usually elevated

Answer 23

a/c/d

Question 24

24. Which ion concentration is the lowest in the EC space?
Select one:
a. Ca++
b. H+
c. Cl–
d. Mg++
e. K+

Answer 24

b

Question 25

``` 25. AVP production is stimulated by: Select one or more: a. excessive physical activity b. hypotension c. CNS lesions d. MDMA (extasy ```

Answer 25

b/c/d

Question 26

``` Useful in the treatment of SIADH: Select one or more: a. glukocorticoids b. restriction of water intake c. V2 receptor antagonists d. 3% NaCl infusion + loop diuretics ```

Answer 26

b/c/d

Question 27

``` 27. It may cause either hypo- or hypernatremia depending on the case: Select one: a. hypothyroidism b. Conn’s syndrome c. diarrhea d. SIADH e. primary polydipsia ```

Answer 27

c