NI524 OMGGGGG

Question 1

Which one of the following are the main responses of chemoreceptors to an increase in PaCO2?

a. A decrease in respiratory rate, minute volume and stimulation of the parasympathetic nervous system.

b. An increase in respiratory rate, a decrease in minute volume and stimulation of the sympathetic nervous system

c. An increase in respiratory rate and minute volume and stimulation of the sympathetic nervous system

d. An increase in respiratory rate, a decrease in minute volume and stimulation of the parasympathetic nervous system

Answer 1

c. An increase in respiratory rate and minute volume and stimulation of the sympathetic nervous system

Question 2

Which one of the following statements explains the effects of noradrenaline?

a. Acts on alpha 1 receptors to cause vasoconstriction and increase BP

b. Acts on glycogen to increase glucogenisis to meet the increased energy demands

c. Acts on renal tubules to cause an increase in sodium reabsorption to maintain BP

d. Acts on beta 2 receptors to cause bronchodilation and increase oxygenation

Answer 2

a. Acts on alpha 1 receptors to cause vasoconstriction and increase BP

Question 3

Which one of the following statements defines the term Ejection Fraction from the ventricles?

a. The percentage of blood ejected from the total volume at the end of systole

b. The percentage of blood ejected from the total volume at the end of dystole

c. The percentage of blood ejected from the total volume at the start of systole

d. The percentage of blood ejected from the total volume at the start of dystole

Answer 3

b. The percentage of blood ejected from the total volume at the end of dystole

Question 4

Which one the following results would a person presenting with Hyperosmolar Hyperglycaemic Syndrome (HHS) expect to have?

a. pH >7.35 but < 7.45 and bicarbonate > 15 mmol but < 22mmol

b. pH > 7.35 but < 7.45 and Bicarbonate > 22 mmol but < 24mmol

c. pH >7.3 but <7.35 and Bicarbonate >22 mmol but <24 mmol

d. pH >7.3 but < 7.35 and bicarbonate >15 but < 22mmol

Answer 4

d. pH >7.3 but < 7.35 and bicarbonate >15 but < 22mmol

Question 5

Which one of the following statements best defines the term relative hypovolaemia?

a. Fluid from the intravascular space stays stagnant

b. Fluid from the intravascular space is lost to the external environment

c. Fluid is pulled from other compartments through osmosis into the intravascular space

d. Fluid from the intravascular space shifts into surrounding tissues

Answer 5

d. Fluid from the intravascular space shifts into surrounding tissues

Question 6

What is the connection between a weak peripheral pulse and the contractility of the left ventricle? (There is one correct answer)

a. As the contractility worsens, stroke volume will increase but this will lead to a reduction in heart rate and the volume of blood directed to the peripheries

b. A weak radial pulse stimulates osmoreceptors to improve blood flow to the heart.

c. As the contractility worsens so stroke volume will decrease and perfusion to his peripheries will reduce

d. His weak peripheral pulse stimulates the release of noradrenaline which vasodilates the blood vessels and reduces venous return.

Answer 6

c. As the contractility worsens so stroke volume will decrease and perfusion to his peripheries will reduce

Question 7

Mr Alba’s BP has changed from 120/84 to 110/90mmHg over the last 20 minutes. Why is this likely to have occurred? There are 2 correct answers.

a. Early signs of sepsis

b. A reduced pre-load

c. Vasoconstriction secondary to fluid loss

d. His temperature has increased.

e. A urinary tract infection

f. Anxiety

Answer 7

b. A reduced pre-load

c. Vasoconstriction secondary to fluid loss

Question 8

Which one of the following would suggest a reduction in renal perfusion?

a. A urine output of 80mls over the next 2 hours

b. A drop in systolic blood pressure with associated dizziness

c. A reduction in serum urea and creatinine values

d. The existence of debris in the urine

Answer 8

b. A drop in systolic blood pressure with associated dizziness

Question 9

Which of the following fluid compartment is/are primarily affected in the presence of hypovolaemia? There is one correct answer.

a. The intravascular space

b. The intracellular space

c. The interstitial space

d. Intracellular and extracellular space

Answer 9

a. The intravascular space

Question 10

Which one of her symptoms below is indicative of a compensatory mechanism response by baroreceptors?

a. Cold hands and feet

b. Intermittent sweating

c. blotchy/mottled appearance of the skin

d. Shivering

Answer 10

a. Cold hands and feet

Question 11

Svetlana is diagnosed with bacterial food poisoning. Her signs and symptoms are vomiting and diarrhoea.

What compensatory mechanism protects Svetlana from the complication of a decreased circulating fluid volume? There is one correct answer.

a. The pituitary gland releases the antidiuretic hormone to stimulate central vasoconstriction and increase cardiac output.

b. Noradrenaline is released in response to triggering of the baroreceptors causing vasodilatation and increased blood pressure.

c. The kidney decreases urine excretion by reabsorbing water and potassium to maintain plasma volume.

d. The adrenal glands release aldosterone to reabsorb sodium and water to maintain plasma volume.

Answer 11

d. The adrenal glands release aldosterone to reabsorb sodium and water to maintain plasma volume.

Question 12

Which of the following are signs and symptoms of mild to moderate dehydration?

There is one correct answer.

a. Light-headedness or headache

b. Hypotension

c. Sunken eyes

d. Irritability and confusion

Answer 12

a. Light-headedness or headache

Question 13

Which of the following results would support the diagnosis of dehydration? There is one correct answer.

a. A raised haemoglobin level

b. A lowered haemoglobin level

c. A raised PaO2 level

d. A lowered PaO2 level

Answer 13

a. A raised haemoglobin level

Question 14

Which of the following presentations would you expect to see as a result of dehydration? There is one correct answer.

a. An increase in preload

b. An increase in stroke volume

c. An increase in pulse rate

d. An increase in systolic blood pressure

Answer 14

c. An increase in pulse rate

Question 15

Insensible fluid loss occurs as a result of which of the following factors? There is one correct answer.

a. Nasogastric drainage

b. A pyrexia

c. Hypotension

d. A urine output of <0.5mls/Kg/hour

Answer 15

b. A pyrexia

Question 16

Which statement describes the cause for a high temperature result? There is one correct answer.

a. Macrophages destroy invading bacteria, which releases hormones into the circulation. Hormones cause the hypothalamus to raise the body temperature.

b. Macrophages destroy invading bacteria, which releases pyrogens into the circulation. Pyrogens cause the hypothalamus to lower the body temperature

c. Macrophages produce pyrogens, which causes the hypothalamus to raise body temperature.

d. Macrophages destroy invading bacteria, which releases pyrogens into the circulation. Pyrogens cause the hypothalamus to raise the body temperature.

Answer 16

d. Macrophages destroy invading bacteria, which releases pyrogens into the circulation. Pyrogens cause the hypothalamus to raise the body temperature.

Question 17

What are the characteristics of respiratory acidosis? Choose 2 options.

a. Excessive CO2 loss with decreased PCO2 and increased pH.

b. Caused by faster rate of breathing.

c. Inefficient elimination of CO2 which causes an accumulation in the blood, thus increasing PCO2 and decreased low pH.

d. Caused by shallow breathing.

Answer 17

c. Inefficient elimination of CO2 which causes an accumulation in the blood, thus increasing PCO2 and decreased low pH.

d. Caused by shallow breathing.

Question 18

What are characteristics of respiratory alkalosis? Choose 2 options.

a. Inefficient elimination of CO2, causing an accumulation in the blood, with increased PCO2 and decreased low pH.

b. Caused by faster rate of breathing.

c. Excessive CO2 loss with decreased PCO2 and increased pH.

d. Caused by shallow breathing.

Answer 18

b. Caused by faster rate of breathing.

c. Excessive CO2 loss with decreased PCO2 and increased pH.

Question 19

What is a compensatory mechanism of respiratory alkalosis?

a. Kidneys excrete more bicarbonate (HCO3).

b. Kidneys try to retain more bicarbonate (HCO3).

c. Slow and shallow breathing to increase PCO2, leading to a decrease in pH.

d. Deeper or more frequent breathes to excrete CO2/PCO2.

Answer 19

a. Kidneys excrete more bicarbonate (HCO3).

Question 20

What is a compensatory mechanism of respiratory acidosis?

a. Deeper or more frequent breathes to excrete CO2/PCO2.

b. Kidneys try to retain more bicarbonate (HCO3).

c. Kidneys excrete more bicarbonate (HCO3).

d. Slow and shallow breathing to increase PCO2, leading to a decrease in pH.

Answer 20

b. Kidneys try to retain more bicarbonate (HCO3).

Question 21

What is metabolic acidosis?

a. A condition such as a renal disease or diarrhoea which causes severe bicarbonate (HCO3) loss, leading to a low HCO3 concentration. Also causes a decrease in pH.

b. Excessive CO2 loss, decreased PCO2 and increased pH.

c. Inability to excrete bicarbonate in the urine leading to an increased pH.

d. Inefficient elimination of CO2 causes an accumulation in the blood. There is an increased PCO2 and low pH.

Answer 21

a. A condition such as a renal disease or diarrhoea which causes severe bicarbonate (HCO3) loss, leading to a low HCO3 concentration. Also causes a decrease in pH.

Question 22

What is metabolic alkalosis?

a. Inefficient elimination of CO2 causes an accumulation in the blood. There is an increased PCO2 and low pH.

b. Inability to excrete excess bicarbonate in the urine leading to an increased pH.

c. Excessive CO2 loss, decreased PCO2 and increased pH.

d. A condition such as a renal disease or diarrhoea which causes severe bicarbonate (HCO3) loss, leading to a low HCO3 concentration.

Answer 22

b. Inability to excrete excess bicarbonate in the urine leading to an increased pH.

Question 23

What is the compensatory mechanism of metabolic acidosis?

a. Kidneys excrete more bicarbonate (HCO3).

b. Kidneys try to retain more bicarbonate (HCO3).

c. Slow and shallow breathing to increase PCO2, leading to a decrease in pH.

d. Deeper or more frequent breathes to excrete CO2/PCO2.

Answer 23

d. Deeper or more frequent breathes to excrete CO2/PCO2.

Question 24

What is a compensatory mechanism of metabolic alkalosis?

a. Kidneys excrete more bicarbonate (HCO3).

b. Kidneys try to retain more bicarbonate (HCO3).

c. Slow and shallow breathing to increase PCO2, leading to a decrease in pH.

d. Deeper or more frequent breathes to excrete CO2/PCO2.

Answer 24

c. Slow and shallow breathing to increase PCO2, leading to a decrease in pH.

Question 25

Which of the following best describes Class II compensatory, hypovolaemic shock?
Choose one answer.

a. a normal Systolic BP, a raised Diastolic BP, a heart rate of 110 bpm and a pale complexion.

b. Systolic and diastolic BP unchanged, with a heart rate of 88 bpm and a normal complexion

c. A reduced pulse pressure, tachycardia and drowsiness

d. Systolic and Diastolic BP reduced, an extended capillary refill time and a weak radial pulse of 120 bpm.

Answer 25

a. a normal Systolic BP, a raised Diastolic BP, a heart rate of 110 bpm and a pale complexion.

Question 26

Which of the following are possible causes of ‘Relative Hypovolaemia’? There are two correct answers

a. Vasoconstriction

b. Anaphylaxis

c. Insensible fluid losses

d. Bronchoconstriction

e. The release of inflammatory mediators

f. The use of salbutamol medication

Answer 26

b. Anaphylaxis

e. The release of inflammatory mediators

Question 27

Which one of the following people are most likely to be at risk of developing acute kidney injury? There are two correct answers

a. A person with a colostomy

b. A person with a long-term urinary catheter

c. A person with relative hypovolaemia

d. A person with Diabetic Ketoacidosis

e. A person with type 2 diabetes

f. A person with a positive fluid balance

Answer 27

c. A person with relative hypovolaemia

d. A person with Diabetic Ketoacidosis

Question 28

Atrial fibrillation is often cited as a risk factor for cardiovascular disease. Why is this? There is one correct answer.

a. The fibrillating atria leads to reduced blood through to the ventricles, reducing stroke volume and perfusion to the body.

b. The fibrillating atria leads to the pooling of blood in the atria, increasing the risk of thrombus formation.

c. The fibrillating atria increase the risk of atherosclerotic plaque formation due to reduced blood flow.

d. The fibrillating atria break down erythrocytes leading to damaged blood vessels that are incapable of carrying oxygen efficiently.

Answer 28

b. The fibrillating atria leads to the pooling of blood in the atria, increasing the risk of thrombus formation.

Question 29

How does the brain compensate effectively for a rise in intracranial pressure caused by an intracerebral bleed? There is one correct answer.

a. It moves some cerebral spinal fluid into the cerebral column.

b. It compresses brain tissue down towards the brain stem.

c. It vasodilates cerebral blood vessels.

d. It stems the bleeding through haematoma formation.

Answer 29

a. It moves some cerebral spinal fluid into the cerebral column.

Question 30

Findings of an ST elevation?

a. Complete obstruction.
Pain does not subside.
Ischaemic changes - myocardial infarction

b. Partial obstruction.
Pain does not subside.
Ischaemic changes to myocardium.

c. Partial obstruction.
Temporary pain that lasts >20 minutes.
Can occur at rest.

Answer 30

a. Complete obstruction.
Pain does not subside.
Ischaemic changes - myocardial infarction

Question 31

Findings of an NSTEMI?

a. Partial obstruction.
Pain does not subside.
Ischaemic changes to myocardium.

b. Complete obstruction.
Pain does not subside.
Ischaemic changes - myocardial infarction

c. Partial obstruction.
Temporary pain that lasts >20 minutes.
Can occur at rest.

Answer 31

a. Partial obstruction.
Pain does not subside.
Ischaemic changes to myocardium.

Question 32

Findings of an unstable angina?

a. Partial obstruction.
Pain does not subside.
Ischaemic changes to myocardium.

b. Partial obstruction.
Temporary pain that lasts >20 minutes.
Can occur at rest.

c. Complete obstruction.
Pain does not subside.
Ischaemic changes - myocardial infarction

Answer 32

b. Partial obstruction.
Temporary pain that lasts >20 minutes.
Can occur at rest.

Question 33

Choose the signs and symptoms of acute coronary syndrome.

a. chest pain/discomfort and can radiate to jaw, shoulders, arm, and back.

b. light-headedness

c. nausea/vomiting

d. Epigastric (upper abdomen) pain

e. Heavy sweating

f. Palpitations.

g. Shortness of breath (dyspnoea)

h. all of the above.

Answer 33

a. chest pain/discomfort and can radiate to jaw, shoulders, arm, and back.

b. light-headedness

c. nausea/vomiting

d. Epigastric (upper abdomen) pain

e. Heavy sweating

f. Palpitations.

g. Shortness of breath (dyspnoea)

h. all of the above.