Description : Which of the following features are present in blood chemistry in uncompensated metabolic alkalosis except? (A) Increased pH (B) Increased bicarbonate (C) Normal chloride (D) Normal pCO2
Last Answer : Answer : D
Description : Blood chemistry shows the following changes in compensated respiratory acidosis: (A) Increased pCO2 (B) Increased bicarbonate (C) Decreased chloride (D) All of these
Description : All the following statements about renal tubular acidosis are correct except (A) Renal tubules may be unable to reabsorb bicarbonate (B) Renal tubules may be unable to secrete hydrogen ions (C) Plasma chloride is elevated (D) Anion gap is decreased
Description : All the following changes in blood chemistry can occur in severe diarrhoea except (A) Decreased pH (B) Decreased bicarbonate (C) Increased pCO2 (D) Increased chloride WATER AND ELECTROLYTE BALANCE 287
Last Answer : Answer : C
Description : Anion gap is normal in (A) Hyperchloraemic metabolic acidosis (B) Diabetic ketoacidosis (C) Lactic acidosis (D) Uraemic acidosis
Last Answer : Answer : A
Description : A young child presents with respiratory distress, worsening over 2 days. Blood gases show a pH of 7.25, a PCO2 of 7.5kPa, a PO2 of 8.5kPa, and a base excess of -4. Which of the ... required. 4) Results are consistent with late severe asthma. 5) Bicarbonate may be necessary to correct the acidosis.
Last Answer : Answers-4 In interpreting blood gas results, the following sequence may be useful: Inspect the pH: Is it low, normal or high? Inspect the CO2: Is it low, normal or high? Inspect the PO2: Is ... excess and normal pH. Bicarbonate is usually only considered if the base deficit exceeds about -8 or 00.
Description : The initial event in respiratory acidosis is (A) Decrease in pH (B) Increase in pCO2 (C) Increase in plasma bicarbonate (D) Decrease in plasma bicarbonate
Last Answer : Answer : B
Description : A 45-year-old solicitor had an onset of severe, crushing, substernal chest pain while attending a football match. He collapsed on his way to the car. Bystander Cardiorespiratory Resuscitation ... His oxyhemoglobin curve is shifted to the left 5) His pulmonary artery pressure is probably elevated
Last Answer : Answers-5 This young patient with severe central chest pain has probably arrested due to myocardial infarction and arrhythmia. His gases reveal high PO2 following 100% O2 but severe acidosis ... no left to right shunting and high pulmonary pressures would be expected after this arrest scenario.
Description : Which of the following statements are true of elevated-anion gap metabolic acidosis? A. Hypoperfusion from the shock state rarely produces an elevated anion gap. B. Retention of sulfuric and phosphoric ... E. Use of lactated Ringer's solution is inappropriate in the treatment of lactic acidosis.
Last Answer : Answer: BC DISCUSSION: An elevated anion gap may be produced by lactic acidosis from shock or by retention of inorganic acids from uremia. Lactated Ringer's solution rapidly corrects the ... . Bicarbonate loss from diarrhea and dilutional acidosis are non-anion gap types of metabolic acidosis
Description : Salicylate poisoning can cause (A) Respiratory acidosis (B) Metabolic acidosis with normal anion gap (C) Metabolic acidosis with increased anion gap (D) Metabolic alkalosis
Description : Anion gap of plasma can be due to the presence of all the following except (A) Bicarbonate (B) Lactate (C) Pyruvate (D) Citrate
Description : The primary event in respiratory alkalosis is (A) Rise in pH (B) Decrease in pCO2 (C) Increase in plasma bicarbonate (D) Decrease in plasma chloride
Description : Anion gap is increased in (A) Renal tubular acidosis (B) Metabolic acidosis resulting from diarrhoea (C) Metabolic acidosis resulting from intestinal obstruction (D) Diabetic ketoacidosis
Description : A 73 year old male presented with an acute attack of gout in his left knee. What is the most likely underlying metabolic cause? 1) decreased renal excretion of uric acid 2) endogenous overproduction of uric acid 3) excessive dietary purine intake 4) lactic acidosis 5) starvation
Last Answer : Answers-1 The aetiology of gout can broadly be divided into cases where there is underexcretion of urate via the kidney (90%) or endogenous overproduction of uric acid (10%) although in practical ... diuretic use. Excessive dietary intake of purines is unlikely to be the main cause in this case.
Description : Anion gap is the difference in the plasma concentrations of (A) (Chloride) – (Bicarbonate) (B) (Sodium) – (Chloride) (C) (Sodium + Potassium) – (Chloride + Bicarbonate) (D) (Sum of cations) – (Sum of anions)
Description : Plasma bicarbonate is decreased in (A) Respiratory alkalosis (B) Respiratory acidosis (C) Metabolic alkalosis (D) Metabolic acidosis
Description : If the body experiences acidosis the respiratory center located in the medulla gets the information and induces the increase of the respiratory frequency. The increment of the respiratory frequency makes the ... of bicarbonate towards the spending of more hydrogen ions and thus the blood pH raises.
Last Answer : How does the breathing process correct alkalosis?
Description : Which of the following is true concerning a 68 year old male with type 2 diabetes diagnosed with type IV renal tubal acidosis? 1) Aminoaciduria would be expected. 2) Fludrocortisone treatment is effective ... 4) Increased urinary bicarbonate would be expected. 5) Normal renal handling of K+ and H+
Last Answer : Answers-2 H+ secretion, sodium reabsorption and ammonia production diminishes. RTA 4 is in effect hyporeninaemic hypoaldosteronism or failure of aldosterone action and thus helped treated with ... particularly. Aminoaciduria and increased urine bicarbonate are features of RTA types 1 and 2.
Description : Which of the following statements about respiratory acidosis are true? A. Compensation occurs by a shift of chloride out of the red blood cells. B. Renal compensation occurs rapidly. C. Retention of ... of respiratory acidosis. E. The ratio of bicarbonate to carbonic acid is less than 20:1.
Last Answer : Answer: CE DISCUSSION: Renal compensation for acute hypoventilation is relatively slow. Depression of the respiratory center by morphine can lead to respiratory acidosis. Renal retention of bicarbonate, ... into red cells combine to increase the ratio of bicarbonate to carbonic acid to 20:1
Description : Normal anion gap in plasma is about (A) 5 meq/L (B) 15 meq/L (C) 25 meq/L (D) 40 meq/L
Description : Why excessive intake of alcohol produces lactic acidosis?
Last Answer : During alcohol oxidation, NADH is generated, which converts pyruvate to lactate.
Description : Which of the following statements about the preparation and storage of blood components is/are true? A. Solutions containing citrate prevent coagulation by binding calcium. B. The ... cells includes development of acidosis, hyperkalemia, and decreased intracellular 2,3DPG (diphosphoglycerate).
Last Answer : Answer: ABD DISCUSSION: After blood has been collected from a donor, it is anticoagulated with a solution containing citrate, which acts by binding calcium. Blood is then separated into its ... transfusion or produce effects other than those predicted based on the content of the unit of blood
Description : During compensation of respiratory alkalosis, all the following changes occur except (A) Decreased secretion of hydrogen ions by renal tubules (B) Increased excretion of sodium in urine (C) Increased excretion of bicarbonate in urine (D) Increased excretion of ammonia in urine
Description : Respiratory acidosis results from (A) Retention of carbon dioxide (B) Excessive elimination of carbon dioxide (C) Retention of bicarbonate (D) Excessive elimination of bicarbonate
Description : Respiratory acidosis is caused by (A) Increase in carbonic acid relative to bicarbonate (B) Decrease in bicarbonate fraction (C) Increase in bicarbonate fraction (E) Decrease in the carbonic acid fraction
Description : Plasma bicarbonate is increased in (A) Respiratory alkalosis (B) Metabolic alkalosis (C) Respiratory acidosis (D) Metabolic acidosis
Description : Acidosis is the condition in which the blood pH is abnormally low. Alkalosis is the condition in which the blood pH is abnormally high. Normal pH levels for the human blood are between 7.35 and 7.45 - slightly alkaline.
Last Answer : How does the breathing process correct acidosis?
Description : In patients receiving massive blood transfusion for acute blood loss, which of the following is/are correct? A. Packed red blood cells and crystalloid solution should be infused to restore oxygen ... should be administered with every 5 units of packed red blood cells to avoid hypocalcemia.
Last Answer : Answer: A DISCUSSION: Patients who are suffering from acute blood loss require crystalloid resuscitation as the initial maneuver to restore intravascular volume and re-establish vital signs. If 2 to 3 liters ... when the infusion of blood proceeds at a rate exceeding 1 to 2 units every 5 minutes
Description : Which of the following concerning the pH of urine is correct? 1) is a useful indicator of the acid/base balance of the blood 2) rises on a vegetarian diet 3) is determined by the concentration of ... lower than 5.5 in renal tubular acidosis 5) would be above 7.0 after prolonged and severe vomiting
Last Answer : Answers-2 c - excretion of ammonium occurs when an acid urine is produced but the pH of urine is of course determined by the concentration of H+ ions d-unable to lower the pH to ... and distal nephron and this perpetuates the metabolic alkalosis until the fluid balance is restored with IV fluids.
Description : Quantitatively, the most significant buffer system in plasma is (A) Phosphate buffer system (B) Carbonic acid-bicarbonate buffer system (C) Lactic acid-lactate buffer system (D) Protein buffer system
Description : Anion gap in plasma is because (A) Of differential distribution of ions across cell membranes (B) Cations outnumber anions in plasma (C) Anions outnumber cations in plasma (D) Of unmeasured anions in plasma
Description : A 0.22 M solution of lactic acid (pKa 3.9) was found to contain 0.20 M in the dissociated form and 0.02 M undissociated form, the pH of the solution is (A) 2.9 (B) 3.3 (C) 4.9 (D) 5.4
Description : Lactic acidosis?
Last Answer : DefinitionLactic acidosis is when lactic acid builds ups in the blood stream faster than it can be removed. Lactic acid is produced when oxygen levels in the body drop.Causes, ... correcting the underlying medical problem that causes the condition.ReferencesOh MS. Evaluation of renal function,
Description : A 54-year-old woman with severe hypercholesterolemia is to be treated with a combination of niacin and atorvastatin. With this drug combination, it is important that the patient be monitored closely for signs of (a) Agranulocytosis (b) Gallstones (c) Lactic acidosis (d) Myopathy (e) Thyrotoxicosis
Last Answer : Ans: D
Description : Metformin is preferred over phenformin because: A. It is more potent B. It is less liable to cause lactic acidosis C. It does not interfere with vitamin B12 absorption D. It is not contraindicated in patients with kidney disease
Last Answer : B. It is less liable to cause lactic acidosis
Description : The major limitation of the thiazolidinediones in the treatment of type 2 diabetes mellitus is: A. Frequent hypoglycaemic episodes B. Hyperinsulinemia C. Lactic acidosis D. Low hypoglycaemic efficacy in moderate to severe cases
Last Answer : D. Low hypoglycaemic efficacy in moderate to severe cases
Description : ___________ drug can cause lactic acidosis. a) Metformin b) Pioglitazone c) Repaglinide d) Glibenclamide
Last Answer : a) Metformin
Description : In severe acidosis, the output of urea is (A) Decreased (B) Slightly increased (C) Highly increased (D) Moderately increased
Description : All of the following statements about uric acid are true except (A) It can be formed from allantoin (B) Formation of uric acid stones in kidneys can be decreased by alkalinisation of urine (C) Uric acid begins to dissociate at pH above 5.8 (D) It is present in plasma mainly as monosodium urate
Description : At the pH of blood 7.4, the ratio between the carbonic acid and bicarbonate fractions is (A) 1 : 10 (B) 1 : 20 (C) 1 : 30 (D) 1 : 40
Description : Which of the following electrolytes is a major cation in body fluid? a) Potassium Potassium is a major cation that affects cardiac muscle functioning. b) Chloride Chloride is an anion. c) Bicarbonate Bicarbonate is an anion. d) Phosphate Phosphate is an anion.
Last Answer : a) Potassium Potassium is a major cation that affects cardiac muscle functioning.
Description : At a pH below the isoelectric point, an amino acid exists as (A) Cation (B) Anion (C) Zwitterion (D) Undissociated molecule
Description : At isoelectric pH, an amino acid exists as (A) Anion (B) Cation (C) Zwitterion (D) None of these
Description : In case of wilson’s disease, the features include all of the following except (A) Progressive hepatic cirrhosis (B) Keyser Fleisher ring (C) Aminoaciduria (D) Urinary excretion of Cu is decreased
Description : Respiratory acidosis is that in which the blood pH is low due to increased retention of carbon dioxide caused by the lowering of the respiratory frequency or by pulmonary diseases that impair ... caused by metabolic disturbances that increase the concentration of bases (alkalis) in the blood.
Last Answer : Where are the chemoreceptors that detect the acidity of the blood and trigger the respiratory compensation located?
Description : A 16 year old male with a day history of malaise, weakness and vomiting. He was diagnosed with Insulin dependent diabetes mellitus 3 years prviously. Which ONE of the following supports a diagnosis of ... serum glucose 14 mmol/l 4) Decreased appetite in the past few days 5) Shallow respirations
Last Answer : Answers-2 a-An unusual but recognised feature particularly in children. However does not support a diagnosis of DKA. b-Suggests metabolic acidosis. c-'Normoglycaemic DKA' can occur and a glucose ... anorexia. e-Respiratory compensation leads to rapid deep (Kussmaul's) breathing. (Dr Mike Mulcahy)
Description : Respiratory acidosis can occur in all of the following except (A) Pulmonary oedema (B) Hysterical hyperventilation (C) Pneumothorax (D) Emphysema
Description : At pH 7.4, the ratio of bicarbonate : dissolved CO2 is (A) 1 : 1 (B) 10 : 1 (C) 20 : 1 (D) 40 : 1
Description : Adverse consequences of excess mineralocorticoid action include the following except: A. Na+ and water retention B. Acidosis C. Aggravation of CHF associated myocardial fibrosis D. Rise in blood pressure
Last Answer : B. Acidosis
Description : The normal concentration of bicarbonate in blood is (A) 21 meq/L (B) 24 meq/L (C) 26 meq/L (D) 30 meq/L