Revision Questions

Question 1

1. GFR would increase if:
   a. There is afferent arteriole constriction
   b. There is efferent arteriole constriction
   c. There is an increase in tissue pressure in Bowman’s capsule
   d. There is an increased release of renin from the JG cells
   e. There is an obstruction of the ureters

Answer 1

b. There is efferent arteriole constriction

Question 2

How would drinking a large amount of water affect osmolarity and volume of the ECF?

a. Decreased osmolarity and increased volume
b. Both would increase
c. No change in osmolarity and increased volume
d. No change in either
Greater increase in ECF volume than ICF volume

Answer 2

a. Decreased osmolarity and increased volume

Question 3

Anti-Diuretic Hormone (ADH):

a. Is produced by the anterior pituitary
b. Inserts aquaporins into all parts of the kidney tubule
c. Causes the hypertonic medullary gradient to be established
d. Is released in response to cellular dehydration
e. Is released in response to increased plasma urea

Answer 3

d. Is released in response to cellular dehydration

Question 4

If Drug A’s clearance is greater than inuline clearance, then which of the following would be true of Drug A?

a. net reabsorption 
b. no reabsorption
c. no secretion
d. net secretion
    e. reabsorbed and secreted

Answer 4

d. net secretion

Question 5

The following acid/base values were obtained:
pH = 7.25, [HCO3-] = 12mmoles/l, Pco2 = 3.3kPa (25mmHg)
a. They are indicative of a respiratory acidosis
b. The reduction in Pco2 is a result of under-breathing
c. The subject has probably been taking bicarbonate of soda
d. It could be related to impaired renal function
e.The subject may have been vomiting very badly

Answer 5

d. It could be related to impaired renal function

Question 6

The following acid/ base values were obtained:
pH = 7.45, [HCO3-] = 12mmoles/l, Pco2 = 2.7kPa (20mmHg)
a. The subject is clearly very unwell
b. The subject is likely to have spent a long time at altitude
c. The subject needs bicarbonate
d. The subject is unlikely to be hypoxic
e.This is typical of a metabolic alkalosis

Answer 6

b. The subject is likely to have spent a long time at altitude

Question 7

The following acid/base values were obtained:
pH = 7.28, [HCO3-] = 36mmoles/l, Pco2 = 8kPa (60mmHg)
a. This is typical of an acute respiratory acidosis.
b. The subject will be excreting large amounts of bicarbonate ions
c. The subject will be excreting large amount of ammonium ions
d. The plasma potassium level is likely to be decreased
e.He has a metabolic alkalosis because of the raised bicarbonate

Answer 7

c. The subject will be excreting large amount of ammonium ions

Question 8

The following antibiotics are generally suitable for empirical treatment of complicated urinary traction infections except:

a. Vancomycin
b. Ciprofloxacin
c. Ceftriaxone
d. Gentamicin
e. Co-amoxiclav

Answer 8

a. Vancomycin

Question 9

What are the features of acute urinary retention?

a. painful inability to void with a palpable or percussible bladder
b. slow stream of micturition with terminal dribbling and frequency
c. painless condition with a palpable or percussible bladder
d. dysuria with frank haematuria
e. bladder pain which is worse when the bladder is full and relieved by voiding

Answer 9

a. painful inability to void with a palpable or percussible bladder

Question 10

What is the commonest mode of presentation for patients with a renal or ureteric stone?

a. loin pain radiating to the flank and/or groin
b. frank haematuria
c. urinary tract infection
d. lower urinary tract symptoms
e. acute urinary retention

Answer 10

a. loin pain radiating to the flank and/or groin

Question 11

What is the commonest type of renal tract stones in adults?

a. calcium phosphate
b. calcium oxalate
c. cystine
d. magnesium ammonium phosphate
e. uric acid

Answer 11

b. calcium oxalate

Question 12

The commonest urological malignancy in patients with painless frank haematuria is:

a. kidney cancer
b. testicular cancer
c. bladder cancer
d. penile cancer
e. prostate cancer

Answer 12

c. bladder cancer

Question 13

A 60 year old man presents with tiredness and malaise. Routine investigations reveal a raised serum creatinine and an estimated GFR of 35ml/min. Which of the following stages of CKD is he in?

a. Stage 1
b. Stage 2
c. Stage 3
d. Stage 4
e. Stage 5

Answer 13

e. Stage 5

Question 14

A 70 year old man complains of poor stream of urine, nocturia and post-micturition dribbling.
Which of the following is the most likely cause?
a. Diabetic neuropathy
b. Urinary tract infection
c. Chronic kidney disease
d. Prostatic hypertrophy
e. Bladder cancer

Answer 14

d. Prostatic hypertrophy

Question 15

For an uncomplicated urinary infection which of the following organism is the most likely cause?

a. Staphylococcus aureus
b. Klebsiella sp
c. Pseudomonas aeruginosa
d. Candida albicans
e. Escherichia coli

Answer 15

e. Escherichia coli

Question 16

Patients with renal failure are often anaemic. What is the best treatment for their anaemia?

a. Oral iron therapy
b. Intravenous iron
c. Vitamin B12
d. Erythropoietin
e. Blood transfusion

Answer 16

d. Erythropoietin

Question 17

A 60 year old man has stage 5 CKD with a serum creatinine of 500 mmol/l, (normal 88-116). Which of the following is likely to be present?

a. Low serum calcium
b. Normal serum calcium
c. Low serum phosphate
d. Normal serum calcium
e. High serum calcium

Answer 17

a. Low serum calcium

Question 18

A 60 year old man has stage 5 CKD with a serum creatinine of 500 mmol/l, (normal 88-116). Which of the following is likely to be present?

a. High serum calcium
b. Low serum phosphate
c. High serum phosphate
d. Normal serum calcium
e. Normal serum phosphate

Answer 18

c. High serum phosphate

Question 19

A 40 year old man was found to have asymptomatic proteinuria and microscopic haematuria during routine employment-related examination. His BP was found to be 160/100mmHg and serum creatinine 170micromol/l (normal 86-116). He has no urinary symptoms. What is the next most important investigation?

a. Chest X-ray
b. Echocardiogram
c. Intravenous urogram
d. Ultrasound of the urinary tract
e. Renal biopsy

Answer 19

d. Ultrasound of the urinary tract

Question 20

A 23 year old woman complains of flank pain, dysuria and frequency of micturition. She has taken ibuprofen for the pain. Her urinalysis shows protein, nitrites and blood. What is the likely diagnosis?

a. Acute pyelonephritis
b. Cystitis
c. Chronic pyelonephritis
d. Reflux nephropathy
e. Analgaesic nephropathy

Answer 20

a. Acute pyelonephritis

Question 21

A 6 year old child presents with swelling of his face and legs. His serum albumin concentration is 18g/l (normal 37-42) and his mother notices that his urine is frothy. What is the most likely diagnosis?

a. Ig-A glomerulonephritis
b. Minimal change disease
c. Focal and segmental glomerulonephritis
d. Membraneous nephropathy
e. Lupus nephritis

Answer 21

b. Minimal change disease

Question 22

Which of the following are classed as loop diuretics?

a. Furosemide
b. Spironolactone
c. Bendroflumethiazide
d. Mannitol
e. Amilorid

Answer 22

a. Furosemide

Question 23

A patient with lung cancer develops the syndrome of inappropriate ADH secretion. Which of the following values for Na+ concentration might be expected to be seen?

a. 140mmol/L
b. 145mmol/L
c. 150mmol/L
d. 138mmol/L
e. 128mmol/L

Answer 23

e. 128mmol/L

Question 24

The following values were made for an elderly female diabetic patient’s creatinine clearance:
24hr urine volume 1.44l, serum creatinine concentration 100mmol/L, urine creatinine concentration 6.6mmoles/L.
a. Clinical features of renal impairment would be expected.
b. Serum creatinine alone indicates impaired renal function.
c. Serum potassium should be measured urgently
d. The data suggest there may be renal impairment.
e. There is reason to suspect an incomplete renal collection.

Answer 24

d. The data suggest there may be renal impairment.

Question 25

The following acid/base values were obtained:
pH =7.50, [HCO3-] = 45mmoles/l, Pco2 = 8kPa (60mmHg)
a. This may be the result of bad diarrhoea
b. The subject will be excreting bicarbonate ions
c. The subject will be excreting ammonium ions
d. The plasma potassium level is likely to be increased
e. The subject has a respiratory acidosis because of the raised Pco2

Answer 25

b. The subject will be excreting bicarbonate ions

Question 26

Which of the following symptoms typically presents with bladder cancer?

Select one:

a. Painless haematuria
b. Loin Pain
c. Urinary retention
d. Incontinence
e. Abdominal Pain

Answer 26

a. Painless haematuria

Question 27

A 44 year old man has a cupful of fresh haemoptysis. He has a four month history of nasal stuffiness, recurrent nose bleeds and oral ulceration. Urinalysis shows blood 3+ and protein 2+. Investigations: serum urea 27.3 mmol/L (2.5–7.0), serum creatinine 342 µmol/L (60–110), PR3-ANCA 89 U/mL (<5). Which of the following is the most likely diagnosis?

Select one:

a. Wegener’s granulomatosis
b. IgA nephropathy
c. systemic lupus erythematosus
d. Churg-Strauss syndrome
e. Kawasaki disease

Answer 27

a. Wegener’s granulomatosis

Question 28

A 42 year old man with stage 5 chronic kidney disease has a lower respiratory tract infection treated with intravenous amoxicillin and intravenous fluid. He has been anuric for the last 23 hours. Investigations: serum sodium 138 mmol/L (137–144), serum potassium 7.4 mmol/L (3.5–4.9), serum chloride 102 mmol/L (95–107), serum bicarbonate 18 mmol/L (20–28), serum urea 32 mmol/L (2.5–7.0), serum creatinine 623 µmol/L (60–110). Which abnormality is an indication for urgent haemodialysis?

Select one:

a. Serum potassium
b. Serum bicarbonate
c. Serum Urea
d. Serum creatinine
e. Anuria

Answer 28

a. Serum potassium

Question 29

A 76 year old man undergoes coronary angiography for investigation of angina. He has type 2 diabetes mellitus and chronic kidney disease stage 3. His current medication is aspirin, atenolol and simvastatin. Investigations: On admission to hospital: serum urea 9.0 mmol/L (2.5–7.0), serum creatinine 125 µmol/L (60–110), Day 4 following coronary angiography: serum urea 11.5 mmol/L (2.5–7.0), serum creatinine 170 µmol/L (60–110), urinalysis negative for protein and blood. What is the likely diagnosis?

Select one:

a. diabetic nephropathy
b. rapidly progressive glomerulonephritis
c. analgesic nephropathy
d. contrast nephropathy
e. interstitial nephritis

Answer 29

d. contrast nephropathy

Question 30

A 32 year old man has one hour of severe pain in the right side of his abdomen and back, radiating to the groin. He is a taxi driver and the pain started while driving. He has no significant past medical history and is taking no regular medication. On examination, he is distressed. His temperature is 36.9°C, pulse 112 bpm and blood pressure 166/94 mmHg. There is tenderness in the right flank. Examination is otherwise normal. Urinalysis shows blood 3+ but no protein. What is the most likely diagnosis?

Select one:

a. acute cholecystitis
b. acute pyelonephritis
c. renal calculus disease
d. appendicitis
e. prolapsed intervertebral disc

Answer 30

c. renal calculus disease

Question 31

A 26 year old woman has urinary frequency and burning dysuria. Culture of mid-stream specimen of urine grows Escherichia coli. Which category does Escherichia coli belong to?

Answer 31

Gram Neg Bacillius

Question 32

A 25 year old woman has right sided loin pain. She is hypertensive with a blood pressure of 168/96 mmHg and has a fullness in her abdomen. Investigations: abdominal ultrasound: polycystic kidneys. Genetic testing confirms she is a heterozygote for adult polycystic kidney disease, an autosomal dominant condition. What is the chance that her son has inherited the condition?

Answer 32

50%

Question 33

A 24 year old woman has 12 hours of dysuria and urinary frequency. On examination, she has suprapubic tenderness. Urinalysis shows blood 2+, and is positive for both leucocytes and nitrites. Investigations: serum creatinine 62 µmol/L (60–110), What is the most likely causative organism?

Answer 33

E Coli

Question 34

A 78 year old man has an episode of visible haematuria. He reports weight loss of 5 kg over the last six months. On examination, he is tender in his left flank. Urinalysis shows blood 3+. Investigations: haemoglobin 172 g/L (115–165), platelet count 248 (150–400), serum creatinine 92 µmol/L (60–110). What is the most likely diagnosis?

Answer 34

Renal Cell Carcinoma

Question 35

A 78 year old woman has incision and drainage of a buttock abscess. She had undergone renal transplantation 16 years previously and had a background history of type 2 diabetes mellitus, hypertension and angina. Her regular medication includes regular aspirin, ramipril, amlodipine, metformin, and prednisolone, and paracetamol as required. Which drug is most likely to impair wound healing?

Answer 35

Prednisolone

Question 36

A 51 year-old male with renal artery stenosis and an elevated blood urea and creatinine, is newly diagnosed as hypertensive. Which of the following agents should be avoided?

Select one:

a. furosemide
b. verapamil
c. doxazosin
d. amlodipine
e. ramipril

Answer 36

e. Rampipril

Question 37

A patient with acute renal failure provides a urine specimen that demonstrates normal osmolality and sodium content. The urine contains no casts, but RBCs are present. Which of the following is the most likely aetiology of this patient’s acute renal failure?

Select one:

a. postrenal cause
b. intrarenal — acute tubular necrosis
c. prerenal cause
d. intrarenal — glomerulonephritis
e. intrarenal — interstitial nephritis

Answer 37

a. postrenal cause

Question 38

A 64 year old man has severe haematemesis and melaena. He has a history of hypertension and peripheral vascular disease and his usual medication is aspirin, ramipril and bendroflumethiazide. On admission, his pulse is 102 bpm and his blood pressure is 88/64 mmHg. His usual medication is stopped and he is treated with high-dose omeprazole, blood transfusion and endoscopic cautery of a bleeding duodenal ulcer. His blood pressure improves to 144/88 mmHg but, over the next 3 days, he passes only 100-200 ml of urine per day and his serum creatinine rises progressively to 540 µmol/L (Range <110 µmol/L) . A urethral catheter is passed – the residual volume is 60 ml. What is the most likely cause of kidney injury?

Select one:

a. acute glomerulonephritis
b. acute tubular obstruction
c. acute interstitial nephritis
d. acute tubular necrosis
e. acute cortical necrosis

Answer 38

d. acute tubular necrosis

Question 39

A 67-year-old man with stage 4 chronic kidney disease, hypertension, type 2 diabetes mellitus, and anaemia of chronic kidney disease comes to the clinic for follow-up. Blood results are shown below:
Serum Calcium	2.34 mmol/L
Creatinine	286µmol/L
Potassium	3.8 mmol/L
Bicarbonate	19 mmol/L
Fasting glucose	3.5mmol/L
Phosphate	1.35mmol/L
Albumin	40 g/L
Urea	12.9mmol/L
Haematocrit	33.1%
Haemoglobin	111 g/L
Mean corpuscular volume	94 μm3
Estimation of glomerular filtration rate is 19 mL/min/1.73 m2. Measurement of which of the following additional laboratory values is most appropriate to screen for renal osteodystrophy in this patient?

Select one:

a. Erythrocyte sedimentation rate
b. Serum intact parathyroid hormone level
c. Serum vitamin B12 level
d. Serum C-reactive protein level
e. Serum thyroid-stimulating hormone level

Answer 39

b. Serum intact parathyroid hormone level

Question 40

A 54-year-old Asian female who has type 2 diabetes mellitus is concerned about her risk for development of renal failure. Which of the following laboratory values is most useful to predict this patient’s risk for developing renal failure within the next 10 years?

Select one:

a. Urine albumin/creatinine ratio
b. Serum creatinine level
c. Haemoglobin A1c level
d. Urea level
e. Serum potassium level

Answer 40

a. Urine albumin/creatinine ratio

Question 41

Considering the renin-angiotensin-aldosterone system: Aldosterone promotes the reabsorption of both sodium and potassium at the distal tubule.
Select one:
True
False

Answer 41

False

Aldosterone Promotes Rebabsorption of Sodium not Potassium

Question 42

The following values were found in an arterial blood sample from a patient. PCO2 = 80 mmHg (10.67kPa); pH = 7.35; HCO3- = 45mmoles/l. From these values it follows that there would have been large amounts of HCO3- in the urine.
Select one:
True
False

Answer 42

False

This is a chronic respiratory acidosis. Activation of renal glutaminase over time has allowed a much greater metabolic compensation, increasing HCO3- concentration of the plasma. This is maintained by reabsorption at the proximal tubule.

Question 43

Regarding the renal tubules. Drugs which block the active removal of NaCl from the ascending loop of Henle are effective in producing diuresis

Select one:
True
False

Answer 43

True

Loop diuretics such as furosemide block the active transport of NaCl out of the ascending limb of the loop of Henle. This means that the hypertonic medullary interstitial gradient is abolished. The loop of Henle is usually responsible for reabsorption of up to 20% of the glomerular filtrate. This fluid therefore passes into the distal tubule. Since the gradient has been abolished, there is no osmotic force to save volume and subjects excrete a large volume of isotonic urine.

Question 44

In a patient in whom sodium intake exceeds sodium output: There would be a decrease in ICF volume.
Select one:
True
False

Answer 44

True

Since the excess sodium is restricted to the ECF by the action of the Na+/K+-pump, water, which is freely permeable across cell membranes, will move out of cells to equalise the osmolarity inside and outside the cell.

Question 45

Regarding the renal tubules.Water movements are determined by antidiuretic hormone in all parts of the tubule.
Select one:
True

Answer 45

False
• Antidiuretic hormone (also known as vasopressin) only controls water movements in the collecting duct. It does this by stimulating the insertion of aquaporin water channels into the luminal membrane.

Question 46

In a patient in whom sodium intake exceeds sodium output: There would be an increased haematocrit.
Select one:
True
False

Answer 46

False
• The excess sodium would be restricted to the ECF by the action of the Na+/K+-pump. The resulting expansion of ECF volume would reduce the haematocrit.

Question 47

Regarding glomerular filtrate: Glomerular filtration rate would be increased if glomerular capillary hydrostatic pressure fell.
Select one:
True
False

Answer 47

False
The glomerular capillary hydrostatic pressure favours filtration so if it increases, the glomerular filtration rate will increase.

Question 48

With regard to the kidneys: The loops of Henle, collecting ducts and vasa recta make up the bulk of the renal medulla.
Select one:
True
False

Answer 48

True

Question 49

In the proximal convoluted tubule: Parathyroid hormone (PTH) impairs the reabsorption of calcium ions.
Select one:
True
False

Answer 49

False
• Low plasma calcium ion concentration stimulates secretion of parathyroid hormone, which then increases calcium ion reabsorption in the kidney. Yet another negative feedback loop.

Question 50

Regarding glomerular filtrate: Over physiological ranges, glomerular filtrate is produced at a rate that is directly proportional to renal arterial blood pressure.
Select one:
True
False

Answer 50

False
Over physiological ranges of renal arterial pressure, pressure autoregulation takes place so that glomerular filtration rate is largely independent of arterial pressure.

Question 51

Regarding glomerular filtrate: Glomerular filtrate is produced at a lower rate by subjects suffering from hypoproteinemia.
Select one:
True
False

Answer 51

False
The osmotic pressure exerted by the plasma proteins will be lower than normal, hence the net filtration pressure will be increase so glomerular filtration rate will be higher than normal

Question 52

The following values were found in an arterial blood sample from a patient. PCO2 = 80 mmHg (10.67kPa); pH = 7.35; HCO3- = 45mmoles/l. From these values it follows that excretion of NH4+ ions would have been increased.
Select one:
True
False

Answer 52

True
As part of the renal compensation for the chronic respiratory acidosis, metabolism of glutamine to generate new HCO3- also results in the production of NH4+, ions which are excreted in the urine

Question 53

Antidiuretic hormone (ADH): Is produced by neurones in the supraoptic and paraventricular nuclei in the hypothalamus.
Select one:
True
False

Answer 53

True
• The cell bodies of the ADH-producing neurones lie in the supraoptic and paraventricular nuclei of the hypothalamus and the hormone is released from their axon terminals in the posterior pituitary.

Question 54

With regard to the kidneys: The bladder is a bag of skeletal muscle.
Select one:
True
False

Answer 54

False

The wall of the bladder is composed of smooth, not skeletal, muscle.

Question 55

Regarding glomerular filtrate: Glomerular filtrate has a composition similar to plasma except for protein content.
Select one:
True
False

Answer 55

True
The process of filtration across the Bowman’s capsule epithelium blocks protein, but little else in the plasma, from filtering.

Question 56

In the proximal convoluted tubule: Parathyroid hormone (PTH) impairs the reabsorption of phosphate ions.
Select one:
True
False

Answer 56

True
PTH increases phosphate excretion in the urine by decreasing phosphate reabsorption in the proximal tubule. This means there is less plasma phosphate for calcium ions to bind to. It therefore tends to increase plasma calcium ion concentration.

Question 57

Considering the renin-angiotensin-aldosterone system: Aldosterone secretion results in reduced urine volume.
Select one:
True
False

Answer 57

True
Increased aldosterone-stimulated Na+ uptake at the distal tubule will cause reabsorption of water there as well. Thus the amount of fluid remaining in the tubule is reduced.

Question 58

Regarding glomerular filtrate: Glomerular filtration rate would be increased if efferent arterioles constricted.
Select one:
True
False

Answer 58

True
Constriction of efferent arterioles (ie those leading away from the glomeruli) will increase hydrostatic pressure upstream at the glomerular capillaries and therefore increase the glomerular filtration rate. Contrast this with the effect of constricting afferent arterioles.

Question 59

The following values were found in an arterial blood sample from a patient. PCO2 = 80 mmHg (10.67kPa); pH = 7.35; HCO3- = 45mmoles/l. From these values it follows that the disturbance is likely to have existed for some days.
Select one:
True
False

Answer 59

True
PCO2 is high, which explains the acidosis. However, HCO3- is also elevated, suggesting that the respiratory disturbance has been going on long enough for the kidneys to compensate.

Question 60

In a patient in whom sodium intake exceeds sodium output: There would be an increase in plasma colloid osmotic pressure.
Select one:
True
False

Answer 60

False
• The excess sodium would be restricted to the ECF by the action of the Na+/K+-pump. The resulting expansion of ECF volume would reduce the concentration of the plasma proteins, thus reducing the plasma colloid osmotic pressure.

Question 61

The following blood gas values were seen in a patient. Which simple Acid/Base Disturbance has he got?
pH = 7.32, [HCO-3]= 15 mM, PCO2  = 30mmHg (4kPa)
• Metabolic Acidosis
• Metabolic Alkalosis
• Respiratory Acidosis (acute)
• Respiratory Acidosis (chronic)
• Respiratory Alkalosis (acute)
Respiratory Alkalosis (chronic)

Answer 61

Metabolic Acidosis

Question 62

The following blood gas values were seen in a patient. Which simple Acid/Base Disturbance has he got?
pH = 7.32, [HCO-3]= 33 mM, PCO2  = 60mmHg (8kPa)
• Metabolic Acidosis
• Metabolic Alkalosis
• Respiratory Acidosis (acute)
• Respiratory Acidosis (chronic)
• Respiratory Alkalosis (acute)
Respiratory Alkalosis (chronic)

Answer 62

Respiratory Acidosis (chronic)

Question 63

The following blood gas values were seen in a patient. Which simple Acid/Base Disturbance has he got?
pH = 7.45, [HCO-3] = 42 mM, PCO2  = 50mmHg (6.7kPa)
• Metabolic Acidosis
• Metabolic Alkalosis
• Respiratory Acidosis (acute)
• Respiratory Acidosis (chronic)
• Respiratory Alkalosis (acute)
Respiratory Alkalosis (chronic)

Answer 63

Metabolic Alkalosis

Question 64

The following blood gas values were seen in a patient. Which simple Acid/Base Disturbance has he got?
pH = 7.45, [HCO-3]= 21 mM, PCO2  = 30mmHg (4kPa)
• Metabolic Acidosis
• Metabolic Alkalosis
• Respiratory Acidosis (acute)
• Respiratory Acidosis (chronic)
• Respiratory Alkalosis (acute)
Respiratory Alkalosis (chronic)

Answer 64

Respiratory Alkalosis (acute)

Question 65

A 75 year old man has the following blood gas values:
pH = 7.31, PCO2 = 7.7.kPa, (58mmHg), [HCO3-] =36mmoles/l.
1. It is likely that he has renal disease.
2. He may have an acute respiratory infection.
3. It is possible that he may have chronic bronchitis.
4. There will be a decrease in his excretion of ammonium ions.
5. His plasma potassium will be reduced.

Answer 65

3. It is possible that he may have chronic bronchitis.

Question 66

The following acid/base values were obtained:
pH = 7.25, [HCO3-] = 12mmoles/l, PCO2 = 3.3kPa (25mmHg)
• They are indicative of a respiratory acidosis
• The reduction in Pco2 is a result of under-breathing
• The subject has probably been taking bicarbonate of soda
• It could be related to impaired renal function
The subject may have been vomiting very

Answer 66

• It could be related to impaired renal function