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Betamax > Physiology 4th LE 2018 (w/ laboratory) > Flashcards

Physiology 4th LE 2018 (w/ laboratory) Flashcards

1
Q

The stomach and the gall bladder is innervated by the:

A

Celiac Ganglion

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2
Q

The Enteric Nervous System (ENS) is able to

a. Initiate intrinsic reflexes in the gut
b. Activate skeletal muscles in the upper esophagus and anus-should be smooth muscle
c. Reset the basic electrical rhythm
d. Totally inhibit gut motility

A

a. Initiate intrinsic reflexes in the gut

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3
Q

The basic electrical rhythm of the GIT is

a. Irregular
b. Not uniformly generated from mouth to anus
c. More intense immediately after a meal
d. Not always followed by a muscle contraction

A

d. Not always followed by a muscle contraction

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4
Q

The spike potential is increased by

a. Stretch
b. Epinephrine
c. Norepinephrine
d. Sympathetics

A

a. Stretch

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5
Q

Growth hormone is stimulated by

a. Amylin
b. Gastrin
c. Ghrelin
d. GLP-2

A

c. Ghrelin

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6
Q

Actively ABSORBED in the salivary gland ductules

a. Cl+
b. K+
c. Na+
d. HCO3-

A

c. Na+

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7
Q

A condition that DECREASES secretion of saliva

a. Smelling food
b. Sleep
c. Chewing food
d. Nausea

A

b. Sleep

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8
Q

What cranial nerve controls esophageal peristalsis in swallowing?

A

vagus (CX)

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9
Q

During the process of swallowing, the:

a. Tongue moves backwards to push the bolus to the palate
b. Hard palate moves upward to close off the nasopharynx
c. Epiglottis slightly elevates to avoid suffocation
d. All of the above are TRUE

A

a. Tongue moves backwards to push the bolus to the palate

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10
Q

Which of the following will help prevent Gastroesophageal reflux?

a. Dark chocolate squares
b. Shot of whiskey
c. Lean grilled steak
d. Peppermint lollipop

A

c. Lean grilled steak - protein increases pressure to prevent GERD

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11
Q

During a meal, fundic contractions are used for:

a. Emptying
b. Grinding
c. Mixing
d. Storing

A

d. Storing - because contractions are tonic only

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12
Q

Mucus and bicarbonate covering the gastric epithelium is DECREASED by:

a. Missing meals
b. Aspirin intake
c. Eating fibrous greens
d. Prostaglandin intake

A

b. Aspirin intake

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13
Q

What kind of food stimulates secretion of Gastric juices?

a. Protein-rich
b. Sugary
c. Alkaline
d. Watery

A

a. Protein-rich - food that increases stimulatory event includes PEPTIDES=proteins

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14
Q

The parietal cell secretes more HCl- when:

a. Gastrin stimulates CCK2 receptors
b. Histamine stimulates H2 receptors
c. Acetylcholine stimulates M3 receptors
d. All of the above are true

A

d. All of the above are true

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15
Q

The vomiting center is located in the _____

A

Medulla

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16
Q

Gastric emptying time is lengthened most by ingesting:

a. Cooked white rice
b. Diluted skim milk
c. Boiled sweet potato
d. Buttered vegetables

A

d. Buttered vegetables - something with oil and fiber

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17
Q

The Migrating Myoelectric Complex (MMC):

a. Stimulates gastric, intestinal and pancreatic secretions
b. Moves ingested matter irregularly in an aboral direction
c. Functions without hormonal control mechanism
d. Initiates contractions in 5 phases

A

a. Stimulates gastric, intestinal and pancreatic secretions

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18
Q

Movement of a 0.6 cm accidentally ingested pebble from the stomach to the ileum occurs during:

a. Peristalsis while eating
b. Phase I of the MMC
c. Segmentation movements
d. Phase III of the MMC

A

d. Phase III of the MMC - MMC is most intense at this phase

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19
Q

The ileocecal sphincter relaxes when:

a. Pressure increases in the cecum
b. Chemicals in the cecum irritate the mucosa
c. Fluid stool fills the terminal ileum
d. Pressure decreases in the terminal ileum

A

c. Fluid stool fills the terminal ileum - others (pressure, chemical) will inhibit peristalsis since it will close the cecum

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20
Q

What reflex enhances the aboral movement of intestinal contents?

a. Ileogastric
b. Anointestinal
c. Gastroileal
d. Intestinointestinal

A

c. Gastroileal - all others inhibit

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21
Q

What kind of colonic contraction can lead to stimulation of the Defecation Reflex?

a. Segmentations
b. Rectal motor complex
c. Haustrations
d. Mass persistalsis

A

d. Mass persistalsis

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22
Q

Defecation is INHIBITED by:

a. ENS stimulation of the sigmoid colon
b. PNS stimulation of internal anal sphincter
c. Contraction of the puborectalis muscle
d. Abdominal wall muscle contraction

A

c. Contraction of the puborectalis muscle

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23
Q

Activation of Trypsinogen to Trypsin along the mucosa of the small intestine is catalyzed by:

a. Cathepsin B
b. Enterokinase
c. Trypsin activator peptide (TAP)
d. Enterostatin

A

b. Enterokinase

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24
Q

Peptide by-product of procolipase activation that regulates fat ingestion:

A

Enterostatin

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25
Q

What hormone INCREASES secretion of HCO3 by the pancreas?

a. Cholecystokinin
b. GIP
c. Secretin
d. Somatostatin

A

c. Secretin

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26
Q

The secretion of bile salts by the hepatocyte is through:

a. Exocytosis
b. Primary active transport
c. Facilitated diffusion
d. Secondary active transport

A

b. Primary active transport

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27
Q

What secondary bile acid is most often excreted in stool?

A

d. Lithocolic

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28
Q

What occurs during the Enterohepatic circulation of bile?

a. Primary bile acids are deconjugated and secreted into the bile canaliculi
b. Bile acid secretion is controlled by amount of bile acids in portal blood
c. Bile release from the gallbladder is stimulated by Secretin
d. Secondary bile acids are produced through the action of pancreatic enzymes

A

b. Bile acid secretion is controlled by amount of bile acids in portal blood

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29
Q

Ghrelin increases appetite by stimulating the:

A

Hypothalamus

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30
Q

A. Cholecystokinin
B. Gastrin
C. Histamine
D. Secretin

Stimulates the ECL cell to secrete Histamine

A

B. Gastrin

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31
Q

A. Cholecystokinin
B. Gastrin
C. Histamine
D. Secretin

Increases contractions of the gallbladder

A

A. Cholecystokinin

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32
Q

A. Cholecystokinin
B. Gastrin
C. Histamine
D. Secretin

Stimulates the bile canaliculi to secrete HCO3-

A

D. Secretin

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33
Q

A. Cholecystokinin
B. Gastrin
C. Histamine
D. Secretin

Stimulates the duodenal mucosa to secrete Enterokinase

A

A. Cholecystokinin

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34
Q

A. Cholecystokinin
B. Gastrin
C. Histamine
D. Secretin

Influences immune system response

A

C. Histamine

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35
Q

Stimulates food intake:

a. GLP-1
b. Oxyntomodulin
c. NPY
d. Leptin

A

c. NPY - the rest makes you feel full

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36
Q

The intestinal microvilli contain:

a. Enzymes for triglyceride digestion
b. Cytosolic enzymes for lactose digestion
c. Sensory receptors sensitive to temperature-
d. Carriers to transport amino acids

A

d. Carriers to transport amino acids
* *
a. Enzymes for triglyceride digestion-enzymes are for carbon protein in microvilli
b. Cytosolic enzymes for lactose digestion-cytosolic enzymes are only for protein
c. Sensory receptors sensitive to temperature-only sensitive to surge in osmolarity

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37
Q

A non-carbohydrate dietary fiber:

a. Cellulose
b. Raffinose
c. Lignin
d. Pectin

A

c. Lignin

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38
Q

Digestion product of pancreatic amylases:

a. Fructose
b. Galactose
c. Glucose
d. Sucrose

A

d. Sucrose - pancreatic amylases only end up with your DISACCHARIDE, the rest are monosaccharides which end up in the brush border

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39
Q

Fructose transporter in the enterocyte

A

GLUT5

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40
Q

What is characteristic of dietary proteins?

a. The adult daily requirement is the same for all sexes
b. Animal proteins are more digestible than plant proteins
c. 50% of ingested protein is lost in the stool
d. There are 20 essential amino acids in edible food

A

b. Animal proteins are more digestible than plant proteins

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41
Q

The function of pancreatic proteases includes:

a. Digestion of isomaltase and α-limit dextrins
b. Increase turnover of brush border enzymes
c. Facilitate breakdown of micelles in the lumen
d. Finish all enzymatic digestion in the lumen

A

b. Increase turnover of brush border enzymes

42
Q

Coconut oil is:

a. Medium chain, saturated
b. Long chain, saturated
c. Medium chain, polyunsaturated
d. Long chain, monounsaturated

A

a. Medium chain, saturated-unique feature of coconut oil

43
Q

In the process of lipid digestion

a. Colipase catalyzes triglyceride digestion
b. Bile salts are ferried to the ileum by micelles
c. Smooth ER facilitates chylomicron synthesis
d. Glycerols are exocystosed into the lymphatics

A

c. Smooth ER facilitates chylomicron synthesis
* *
a. Colipase catalyzes triglyceride digestion-colipase does not catalyze and does not digest lipids
b. Bile salts are ferried to the ileum by micelles-fat is ferried to the ileum
d. Glycerols are exocystosed into the lymphatics-diffuse into the blood stream

44
Q

What will DECREASE the amount of lipids absorbed from the intestine?

a. Ingestion of fiber while ingesting fat
b. Complete resection of the ileum
c. Absence of pancreatic colipase
d. Destruction of brush border enzymes

A

a. Ingestion of fiber while ingesting fat
* *
b. Complete resection of the ileum-no effect on absorption
c. Absence of pancreatic colipase-slows down digestion only
d. Destruction of brush border enzymes-not used for lipids

45
Q

The liver is used for

a. Storage of water soluble vitamins-
b. Conjugation of bile acids
c. Filtering of endotoxins from hepatic artery
d. All of the above are TRUE

A

b. Conjugation of bile acids
* *
a. Storage of water soluble vitamins- lipid -soluble vitamins
c. Filtering of endotoxins from hepatic artery-portal vein

46
Q

Sodium is primarily absorbed in the intestines via:

a. Ligand-gated channels sensitive to hormones
b. Carriers through facilitated diffusion
c. Primary active transport with hydrogen ions
d. Secondary active transport with nutrients

A

d. Secondary active transport with nutrients

47
Q

Only around 0.5 to less than a liter of fluid is actively secreted into the intestines by the

a. Salivary glands
b. Pancreas
c. Gallbladder
d. Intestinal mucosa

A

c. Gallbladder-the rest more than a liter

48
Q

A nutritional benefit because of the presence of bacteria in the intestines

A

Short chain fatty acids from unabsorbed fiber

49
Q

Which is NOT a major mineral requirement

a. Calcium
b. Magnesium
c. Iron
d. Phosphorus

A

c. Iron-part of trace minerals the rest are major minerals

50
Q

According to the current dietary recommendations of MyPlate.gov (that has replaced the food pyramid) around what percentage of daily food intake should be composed of fruits and vegetables?

a. 15%
b. 25%
c. 40%
d. 50%

A

d. 50%

51
Q

Autoregulation of renal blood flow refers to

A

Renal blood flow being relatively constant over a wide range of systemic arterial

52
Q

Insulin clearance will increase due to:

a. Dilation of afferent and efferent arteriole
b. Dilation of afferent and constriction of efferent arteriole
c. Constriction of afferent and efferent arteriole
d. Constriction of afferent arteriole and dilation of efferent arteriole

A

b. Dilation of afferent and constriction of efferent arteriole
* *Inulin is neither reabsorbed or secreted, so increased clearance happens with increase GFR

53
Q

When the kidney is inflamed, albumin may appear in the urine because:

a. Reduced active transport of sodium ion reduces co-transport of albumin
b. more albumin enters the proximal tubule in the glomerular filtrate
c. reabsorption of albumin from the proximal tubule is inhibited
d. increased peritubular blood flow makes more albumin available for diffusion into the tubule
e. secretion of the albumin into the distal tubule and collecting ducts is increased

A

b. more albumin enters the proximal tubule in the glomerular filtrate

54
Q

The rate of water reabsorption from the proximal tubule is determined primarily by the:

a. Rate of dissolved particle (solute) reabsorption from the proximal tubule
b. Concentration of ADH (antidiuretic hormone) in the blood
c. Osmotic pressure developed by plasma proteins in the proximal tubule
d. Active transport of water molecules by the proximal tubule cells
e. Passive filtration due to high hydrostatic pressure in the proximal tubule

A

a. Rate of dissolved particle (solute) reabsorption from the proximal tubule-the rate of absorption of proximal tubule is dependent on active processes and water will follow when you reabsorb the solutes
* *
b. Concentration of ADH (antidiuretic hormone) in the blood- ADH does not work in the PCT
c. Osmotic pressure developed by plasma proteins in the proximal tubule- no plasma proteins in proximal tubule
d. Active transport of water molecules by the proximal tubule cells- Transport of water is passive

55
Q

As the blood passes along the glomerular capillaries from afferent to efferent arteriole, the net filtration pressure:

a. Increases
b. Decreases
c. Remains constant

A

b. Decreases-as the hydrostatic pressure pushes fluid out of the capillary, the hydrostatic pressure eventually decreases, so the net filtration pressure will eventually decrease as the blood goes towards the efferent arteriole

56
Q

Sodium is actively reabsorbed from the renal tubule in what nephron segment?

a. Proximal tubule-NaK exchange or Na-H+ exchange
b. Distal tubule-Na-H+ exchange
c. Thick ascending loop of Henle-NaK2Cl exchange
d. All of the above

A

d. All of the above-all are active transport

57
Q

In the proximal tubule, an antibiotic like penicillin is:

a. Actively reabsorbed from the tubule
b. Actively secreted into the tubule
c. Passively reabsorbed from the tubule
d. Metabolized by the tubule cells

A

b. Actively secreted into the tubule-penicillin is removed

58
Q

In a normally hydrated person, the concentration of creatinine is expected to be highest at the:

a. Glomerular filtrate
b. End of the proximal tubule
c. End of the loop of Henle
d. Collecting duct

A

d. Collecting duct-because creatinine is filtered at the glomerulus and secreted in tubule so greatest concentration of creatinine is at the collecting duct

59
Q

A person lost the function of half his nephrons because of renal degenerative disease. Assuming that the person survives and reaches a new steady state and body urea production remains normal, which of the following would be expected to DECREASE below normal?

a. Plasma urea concentration
b. Renal urea clearance
c. Renal urea secretion
d. Urine urea concentration

A

b. Renal urea clearance-with destruction of nephrons, the GFR will decrease. The remaining nephrons try to compensate by increasing function, but will not be able to do the work of 2 kidneys. So over all GFR will be less than normal and clearance of urea will decrease
* *
a. Plasma urea concentration-will increase because remaining nephrons will be unable to excrete all that needs to be excreted
c. Renal urea secretion-the remaining tubules try to compensate so will be greater than normal, but not approximate the work
d. Urine urea concentration-increase in the urine, but it will not be enough to remove all the urea in the blood so the clearance will be lower than normal

60
Q

The following values are measured for potassium ion in a human subject:
Plasma K+ = 5 meq/liter Urine K+ = 50 meq/liter Renal creatinine clearance= 80ml/min Urine formation rate = 1.5ml/min
This patient’s potassium clearance (in ml/min)is closest to which of the following?
A. 5
B. 7.5
C. 15
D. 50
E. 75

A

C. 15

**Clearance=(urine flow x urine concentration)/plasma concentration =(1.5 ml/min x 50 meq/L)/5 meq/L =15mL/min

61
Q

The following values are measured for potassium ion in a human subject:
Plasma K+ = 5 meq/liter Urine K+ = 50 meq/liter Renal creatinine clearance= 80ml/min Urine formation rate = 1.5ml/min
Assuming the subject is normal, what will you conclude about potassium?
a. Filtered only
b. Secreted only
c. Reabsorbed but not secreted or filtered
d. Filtered and secreted
e. Filtered and reabsorbed

A

e. Filtered and reabsorbed - If creatinine clearance is 80mL/min, the clearance of K+ which is 15mL/min is less, so the K+ is filtered and reabsorbed since its clearance is less than the clearance of creatinine which is an estimate of GFR

62
Q

In a patient with severe renal artery stenosis (narrowing), all of the following are expected to be above normal EXCEPT:

a. hydrostatic pressure in the glomerularcapillaries
b. plasma angiotensin II concentration
c. plasma renin concentration
d. systemic arterial blood pressure

A

a. hydrostatic pressure in the glomerularcapillaries – stenosis of the renal artery, so smaller caliber of vessel - lower blood flow from the renal artery to the afferent arteriole, thus lower hydrostatic pressure at the glomerulus - lower GFR
* *
b. plasma angiotensin II concentration- this increases because of increased renin secretion
c. plasma renin concentration - this is increased because with lower GFR, lower tubular load of NA+ causes increased renin secretion
d. systemic arterial blood pressure-this increases due to increased renin and angiotensin

63
Q

Secretion of atrial natriuretic peptide (ANP) is stimulated by an increase in:

a. blood plasma osmolality above normal
b. systemic arterial pressure
c. cardiac contractility
d. venous blood volume and atrial pressure

A

d. venous blood volume and atrial pressure- these 2 will stretch the receptors at the right atrium that cause release of ANP, other choices have no effect

64
Q

What is the effect of increased renin secretion on the sodium and potassium excretion in the urine?

a. Increased Na+ and K+ excretion
b. Increased Na+ excretion and decreased K+ excretion
c. decreased Na+ excretion and increased K+ excretion
d. Decreased Na+ and K+ excretion

A

c. decreased Na+ excretion and increased K+ excretion-increased RAAS will increase reabsorption of Na+ so its excretion will decrease, and increase excretion of K+

65
Q

Stimulation of the osmoreceptors in the hypothalamus would be expected to cause all of the following to increase EXCEPT

a. ADH release from the pituitary
b. water reabsorption from the renal collecting duct
c. rate of urine formation
d. osmolality of urine

A

c. rate of urine formation-not dependent on ADH, but dependent on GFR

66
Q

In a person with normal ADH levels in the blood, which segment of the juxtamedullary nephron has the lowest osmolality of the filtrate?

a. Bowman’s capsule
b. Proximal tubule
c. descending thin limb of the loop of Henle
d. at the start of the distal collecting tubule

A

d. at the start of the distal collecting tubule - osmolality of fluid is approximately 100 mOsm

67
Q

Drinking alcohol will cause excretion of a:

a. large volume of concentrated urine
b. small volume of concentrated urine
c. large volume of dilute urine
d. normal volume of urine of normal osmolality

A

c. large volume of dilute urine – alcohol inhibits the action of ADH, so inhibits facultative reabsorption of water

68
Q

Which of the following would lead to the highest rate of ADH secretion and release?

a. drinking two liters of distilled water
b. infusion of two liters of normal saline solution
c. infusion of two liters of plasma
d. drinking two liters of sea water

A

d. drinking two liters of sea water- will cause shrinkage of osmoreceptors as water is drawn out of ICF to the ECF that has increased its osmolality with addition of hypertonic solution
* *
a. drinking two liters of distilled water -will lead to hypoosmotic volume of expansion of ECF, osmoreceptors will swell, not shrink(shrink stimulates osmoreceptors)
b. infusion of two liters of normal saline solution-ECF volume will expand, but osmolality is the same ICF, no net movement of water between compartments
c. infusion of two liters of plasma- same as B

69
Q

A runner who ran a 10K marathon without taking stops to drink is expected to have an elevated:

a. serum osmolality
b. ECF volume
c. ICF volume
d. sodium excretion

A

a. serum osmolality- because you lost more water than electrolytes from the ECF
* *
b. ECF volume-will decrease as you lost water from the ECF
c. ICF volume- will slightly decrease, as water is drawn out of ICF to ECF with resulting increased ECF osmolality
d. sodium excretion-will be less because you lost NaCl in sweat

70
Q

If a male patient’s body weight is 70kg, the total body water is approximately

a. 40 kg
b. 47kg
c. 50kg
d. 57kg

A

b. 47kg-best answer since 60% of 70 is 42; other books will give it as 2/3 of BW is water, and using this formula, 70 x 2/3=47kg

71
Q

A patient who is febrile is expected to have an increase in all of the following EXCEPT:

a. serum osmolality
b. insensible water loss
c. urine specific gravity
d. water excretion

A

d. water excretion- because you will conserve water due to increased insensible water loss in fever and this will trigger ADH secretion. A to C will increase and water excretion will decrease

72
Q

In a patient who had diarrhea, which of the following is expected to decrease?

a. tubular reabsorption of water
b. reabsorption and formation of HCO3
c. secretion of ADH
d. ECF volume

A

d. ECF volume-A to C will increase to compensate for loss of water and electrolytes in diarrhea, and due to this loss, the ECF volume will decrease

73
Q

The normal glomerular filtration rate in an adult (in ml/min) is:

a. 125
b. 150
c. 175
d. 180

A

a. 125

* *GFR=Kf x NFP=12.5ml/mm/min x 10 mmHg =125 ml/min

74
Q

The glomerular filtration rate will increase due to afferent arteriolar dilation in the presence of the following:

a. nitric oxide
b. atrial natriuretic peptide
c. high dose of angiotensin II
d. all of the above
e. A and B only

A

A and B only

75
Q

Mesangial cells contract in the presence of:

a. ANP
b. Dopamine
c. Angiotensin II
d. cAMP

A

c. Angiotensin II-most potent constrictor

76
Q

A normal 70 kg male subject is expected to have a

a. renal plasma flow of 650 ml/min
b. renal blood flow of 1200ml/min
c. GFR of 125 ml/min
d. all of the above are TRUE

A

d. all of the above are TRUE

77
Q

Facultative water reabsorption is due to the:

a. effect of ANP and increased reabsorption of tubular Na+
b. effect of ADH secretion and decrease excretion of water in urine
c. secretion of aldosterone and increased reabsorption of potassium
d. increased tubular load of sodium with increased GFR

A

b. effect of ADH secretion and decrease excretion of water in urine

78
Q

A patient has glycosuria if:

a. the tubular glucose load > than Tm for glucose
b. GFR > than transport maximum
c. both A and B are TRUE

A

a. the tubular glucose load > than Tm for glucose

79
Q

Fixed acids are mostly derived from

a. Fruits
b. Vegetables
c. Meat
d. Whole grains

A

c. Meat

* *fruits and veggies-alkali

80
Q

H+ is secreted mostly as (though they can be excreted as titratable acids also)

a. NH4+
b. H2SO4
c. H2PO4
d. H2CO3

A

a. NH4+

81
Q

An increase in plasma pH is seen in persons with:

a. fruit and vegetable diet
b. kidney failure
c. persistent diarrhea
d. COPD

A

a. fruit and vegetable diet - alkali

82
Q

What plasma pH is no longer compatible with life?

a. 6.6
b. 6.8
c. 7.3
d. 7.7

A

a. 6.6

83
Q

A 50 y/o chronic asthmatic complained of shortness of breath and frequent coughing. Breathing was shallow. Breath sounds were distant. Blood gas showed: pH= 7.25 pCO2= 65mmHg HCO3= 35

He has____

a. metabolic acidosis
b. metabolic alkalosis
c. respiratory acidosis
d. respiratory alkalosis

A

c. respiratory acidosis -low pH and high pCO2

84
Q

A 50 y/o chronic asthmatic complained of shortness of breath and frequent coughing. Breathing was shallow. Breath sounds were distant. Blood gas showed: pH= 7.25 pCO2= 65mmHg HCO3= 35

Compensation for this acid-base imbalance involve the following EXCEPT

a. reabsorption of new HCO3
b. excretion of CO2
c. tubular NH4 secretion
d. H+ secretion by type A intercalated cells

A

b. excretion of CO2

85
Q

A 40 y/o man developed diarrhea passed watery and voluminous stools 10-15 x a day. He became weak and was rushed to the ER. BP=100/70 CR=110/min RR=25/min. Breathing was deep. CBC and Stool exam were normal. Serum sodium and potassium were low. ABG showed: pH = 7.25 pCO2 = 24mmHg HCO3 = 10 meq/L

He has:

a. metabolic acidosis
b. metabolic alkalosis
c. respiratory acidosis
d. respiratory alkalosis

A

a. metabolic acidosis - low pH and low HCO3

86
Q

A 40 y/o man developed diarrhea passed watery and voluminous stools 10-15 x a day. He became weak and was rushed to the ER. BP=100/70 CR=110/min RR=25/min. Breathing was deep. CBC and Stool exam were normal. Serum sodium and potassium were low. ABG showed: pH = 7.25 pCO2 = 24mmHg HCO3 = 10 meq/L

Acid base status is due to the loss of?

a. HCO3-
b. CO2
c. K+
d. Na+

A

a. HCO3-

87
Q

An 18 y/o college student was brought to the ER due to rapid breathing and carpopedal spasm. Few hours prior to consultation, she felt tautness of the face with tingling sensation of the extremities while she was hyperventilating uncontrollably.

She is expected to have the following gas values:

a. pH=7.50 HCO3 = 20meq/L pCO2=25mmHg
b. pH=7.40 HCO3=23 meq/L pCO2=35mmHg
c. pH=7.35 HCO3=24meq/L pCO2=40mmHg
d. pH=7.25 HCO3=27meq/L pCO2=50mmHg

A

a. pH=7.50 HCO3 = 20meq/L pCO2=25mmHg - blew off most of the CO2)

88
Q

An 18 y/o college student was brought to the ER due to rapid breathing and carpopedal spasm. Few hours prior to consultation, she felt tautness of the face with tingling sensation of the extremities while she was hyperventilating uncontrollably.

She was ordered to breathe into a paper bag. What is the reason behind this?

a. Limit the amount of oxygen being inhaled
b. Re-breathe the CO2 that was expired
c. Create a good mixture of both O2 and CO2
d. All of the above

A

b. Re-breathe the CO2 that was expired

89
Q

True or False

  1. To avoid tensing of the abdominal wall, the patients arms must be folded behind the head
  2. Auscultation of the abdomen must be done before palpation
  3. Auscultation should be done only at one area of the abdomen to avoid missing the bowel sounds
  4. The usual site of liver’s upper border by percussion is at the 3rd intercostal space
  5. The normal range of liver based on percussion and palpation at the MCL is 4-12cm
A
  1. False
  2. True
  3. False
  4. False
  5. False
90
Q

In the concentration test, the amount of water intake at the dinner time on the night prior to urine collection is

a. 250mL
b. 270mL
c. 300mL
d. 350mL

A

b. 270mL

91
Q

In the same procedure, you are allowed to drink

a. Water
b. Tea
c. Soup
d. All of the above

A

a. Water

92
Q

The first void during urine concentration test is used as a sample for testing

a. True
b. False

A

a. True

93
Q

In the dilution test, which of the following are you allowed to drink with the meal prior to drinking the test substance

a. Tea
b. Fruit juice
c. Water
d. Coffee

A

c. Water

94
Q

How much water are you to drink in the dilution test?

a. 500mL
b. 1000mL
c. 1500mL
d. 2000mL

A

c. 1500mL

95
Q

How much time should you take in the drinking the test substance in the dilution test?

a. 30 minutes
b. 45 minutes
c. One hour

A

a. 30 minutes

96
Q

The first sample immediately after drinking the test substance in the dilution test has the greatest volume

a. True
b. False

A

b. False

97
Q

In the 24 hour urine collection, the first void is labelled as HOUR ZERO

a. True
b. False

A

b. False

98
Q

In the 24 hour urine collection, the relationship between total input and output is

a. Total input > total output
b. Total input = total output
c. Total input

A

a. Total input > total output

99
Q

Which of the following are you supposed to record in the 24 hour urine collection test

a. Time and type of fluid taken in
b. Ambient temperature and activity
c. Urine volume, color, transparency and specific gravity
d. All of the above
e. B & C only

A

d. All of the above

100
Q

Mountain Dew
Urine volume:
Specific gravity:
Reason for findings:

A

Mountain Dew
Urine volume: Increase
Specific gravity: Decrease
Reason for findings: Contain caffeine, a diuretic which will increase the glomerular filtration rate – decrease Na reabsorption and water reabsorption – increase urine volume

101
Q

Buko juice
Urine volume:
Specific gravity:
Reason for findings:

A

Buko juice
Urine volume: increase
Specific gravity: Normal
Reason for findings: Isosmotic Pressure diuresis

102
Q

Complete the flow chart:

Serum Osmolarity => stimulate osmoreceptors => 1. ______ => 2. _____ => increased water reabsorption => 3. _______

A
  1. Decreased ADH secretion
  2. Increased Water permeability of DCT, Aquaporins inserted in DCT
  3. Increased urine osmolarity, Concentration of urine, decreased urine volume

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