Question 1

Which is incorrect with regards to the fluid and its content?
A)Normal Saline - 150mmol Na+/L
B)Hartmans - 131mmol Na+/L
C)Hartmans -131mmolCl-/L
D)D5W- 50gm glucose/L
E)Hartmans- 5 mmol K+/L

Accepted Answer

Hartmans solution contains 111mmol Cl-/L

Question 2

Which is not a possibility in the ECG of a pt with hypokalemia?
A)prolong PR interval
B)prominent U waves
C)T wave flattening
D)Prolonged QT interval
E)T wave inversion in praecordial leads

Accepted Answer

Hypokalemia typically causes a shortened QT interval, not a prolonged one.

Question 3

Which is not a cause of hypokalemia?
A)insulin administration
B)adrenaline infusion
C)alkalosis
D)toluene toxicity
E)digoxin OD

Accepted Answer

Digoxin overdose typically leads to hyperkalemia, not hypokalemia, because it inhibits the Na+/K+ ATPase pump, leading to an increase in extracellular potassium.

Question 4

Which of the drugs below are not associated with hypokalemia?
A)loop diuretics
B)corticosteroids
C)gentamicin
D)amiloride
E)theophylline

Accepted Answer

Amiloride is a potassium-sparing diuretic, which means it helps the body retain potassium, unlike the other options listed which can cause or are associated with hypokalemia (low potassium levels).

Question 5

Which contains the largest amount of K+?
A)two Slow K tablets
B)2 chlorvescent tablets
C)15ml of Kayciel
D)one gram iintravenous KCL
E)a banana

Accepted Answer

The answer of Which contains the largest amount of K+?
A)two...

Question 6

A rise in the pH by 0.1 causes what decrease in serum K+?
A)0.1 mEq/L
B)0.25 mEq/L
C)0.5mEq/L
D)0.7mEq/L
E)1.0mEq/L

Accepted Answer

A rise in pH by 0.1 is associated with a decrease in serum potassium (K+) levels by approximately 0.5 mEq/L due to the shift of potassium into cells.

Question 7

Which does not shift K+ into cells?
A)insulin
B)dextrose
C)NaHCO3
D)Salbutamol
E)resonium

Accepted Answer

Resonium (sodium polystyrene sulfonate) is a potassium-binding resin used to treat hyperkalemia (high blood potassium levels) by removing potassium from the body through the gastrointestinal tract, rather than shifting potassium into cells. Insulin, dextrose, NaHCO3 (sodium bicarbonate), and salbutamol are all agents that can cause a shift of potassium into cells, thereby lowering plasma potassium levels temporarily.

Question 8

What is seen earliest in an ECG of hyperkalemia?
A)Sine wave
B)Peak T wave
C)Flattened p wave
D)QRS widening
E)AV disocciation

Accepted Answer

Peak T waves are typically the earliest sign of hyperkalemia on an ECG, reflecting the effects of increased potassium levels on cardiac myocytes.

Question 9

To diagnose SIADH as the cause of hyponatremia which must not be present?
A)hypovolemia
B)hypotonicity
C)no cardiac/renal/ hepatic failure
D)urine osmolality >100ml/kg
E)urinary Na >20 mmol/ml

Accepted Answer

SIADH is characterized by euvolemic hyponatremia, so hypovolemia must not be present.

Question 10

which statement is incorrect?
A)hyperlipidaemia can cause an artificially low Na+
B)if the hyponatremia is known to be of less than 48 hours duration it can be corrected quickly
C)in chronic hyponatremia, the Na+ should not be raised by more than 0.5mmol/l/hr
D)if the Na+ level is raised too quickly in a pt with chronic hyponatremia it vauses an increase in ICP
E)central pontine myelinolysis is caused when hypernatremia is corrected to quickly

Accepted Answer

Central pontine myelinolysis is caused when hyponatremia, not hypernatremia, is corrected too quickly.

Question 11

Which neoplasm is not characteristically associated with SIADH?
A)mesothelioma
B)bronchogenic carcinoma
C)breast
D)prostate
E)bladder

Accepted Answer

Breast cancer is less characteristically associated with SIADH (Syndrome of Inappropriate Antidiuretic Hormone) compared to the other options. SIADH is more commonly associated with lung cancer, particularly small cell lung cancer, and other malignancies like those of the bladder, prostate, and mesothelioma, but it is less commonly associated with breast cancer.

Question 12

Which drug is not well known to cause hyponatremia?
A)sertraline
B)amitryptilline
C)ecstasy
D)carbamazepine
E)roxithromycin

Accepted Answer

Roxithromycin is not well known to cause hyponatremia. Hyponatremia is a condition characterized by low sodium levels in the blood, which can be caused by various drugs. Sertraline, amitriptyline, ecstasy, and carbamazepine are all known to potentially cause hyponatremia, either through the syndrome of inappropriate antidiuretic hormone secretion (SIADH) or other mechanisms. Roxithromycin, an antibiotic, does not have a well-documented association with hyponatremia.

Question 13

With regards to hypernatremia which is incorrect?
A)it should not be corrected greater than 0.5mmol/L/hr
B)is usually associated with inadequate water intake
C)Normal Saline should not be used if the pt is hypovolemic and hypotensive
D)If associated with hypervolemia then frusemide should be used
E)It is clinically manifest by primarily neurological effects

Accepted Answer

Normal Saline can be used in the management of hypovolemic and hypotensive patients with hypernatremia to restore intravascular volume, contrary to the statement in option C.

Question 14

w.th regards to Calcium which statement is incorrect?
A)the normal correct range is 2.1-2.5
B)the ionized correct range is 1.14-1.3
C)to correct for the low albumin add 0.1 to the total calcium for every 4 the albumin is below 36
D)the ionized calcium increases by 0.05 for every 0.1 drop in pH
E)calcium chloride has less elememtal calcium than calcium gluconate

Accepted Answer

Calcium chloride actually contains more elemental calcium compared to calcium gluconate. Calcium chloride is about 27% elemental calcium, while calcium gluconate contains about 9% elemental calcium.

Question 15

What is not a cause of hypercalcemia?
A)post prandial measurement
B)tuberculosis
C)lung Ca
D)hypomagnasemia
E)renal failure

Accepted Answer

The answer of What is not a cause of hypercalcemia?
A)post...

Question 16

Which is incorrect with regards to hypocalcemia?
A)it causes QT prolongation
B)treatment with calcium may not work if magnesium is not given as well
C)i.v administation of calcium requires cardiac monitoring
D)it is seen in pancreatitis
E)hyperventilation produces tetany by causes a fall in the total body calcium

Accepted Answer

Hyperventilation causes tetany not by reducing total body calcium but by causing alkalosis, which leads to increased binding of calcium to albumin, thereby decreasing the ionized (or bioavailable) calcium fraction. This results in symptoms of hypocalcemia despite normal total body calcium levels.

Question 17

Which is not true of hypomagnasemia?
A)it increases SA node automaticity
B)it causes pre eclampsia
C)it prolongs the QT increasing the risk of Toursades
D)it is associated with a 2-3 times increased risk of AF and SVT post AMI
E)symptoms include weakness, lethargy, and poorly controlled AF despite adequate digoxin

Accepted Answer

Hypomagnesemia does not cause pre-eclampsia; instead, it is often associated with cardiovascular issues, such as increased SA node automaticity, prolonged QT interval which increases the risk of Torsades de Pointes, and an increased risk of atrial fibrillation and supraventricular tachycardia post-acute myocardial infarction. Symptoms can include weakness, lethargy, and poorly controlled atrial fibrillation despite adequate digoxin levels. Pre-eclampsia is a condition related to high blood pressure during pregnancy, not directly caused by low magnesium levels.

Question 18

Which is not true with regards to hypermagnesemia?
A)it is nearly always seen in renal failure
B)it causes nausea, vomiting, loss of deep tendon reflexes, drowsiness and hypotension
C)it causes hypocalcemia
D)if an overdose is taken, Calcium should be given as it is direct antagonist of magnesium
E)it causes widening of the QRS

Accepted Answer

Hypermagnesemia does not cause hypocalcemia. Instead, it can lead to symptoms such as nausea, vomiting, loss of deep tendon reflexes, drowsiness, hypotension, and in severe cases, it can affect cardiac conduction, but it does not directly cause hypocalcemia.

Question 19

Which equation is incorrect?
A)anion gap =(Na+ + K+) - (Cl- + HCO??)
B)calculated serum osmolality = 2(Na + urea +glucose)
C)paO? = pIO? - paCO?/0.8
D)the expected CO? in metabolic acidosis = 1.5 × HCO?? + 8
E)the expected CO? in metabolic alkalosis =0.9× HCO?? + 9

Accepted Answer

The correct formula for calculated serum osmolality is 2(Na+) + (Glucose / 18) + (BUN / 2.8) or a similar variation depending on the units used for glucose and urea (BUN - Blood Urea Nitrogen). The formula provided in option B incorrectly adds urea and glucose directly to sodium without accounting for their units or conversion factors.

Question 20

Which statement is incorrect?
A)the normal Aa gradient is <age/4
B)in respiratory alkalosis, for every drop of 10mmHg of pCO2, the HCO3- drops 1 mmol/L acutely
C)in chronic respiratory alkalosis, for every drop of 10mmHg of pCO2, the HCO3- drops 2mmol/L
D)in acute respiratory acidosis, for every 10mmHg rise in pCO2 ,the HCO3 rises 1mmol/L
E)in chronic respiratory acidosis, for every 10mmHg rise in pCO2 ,the HCO3 rises 2mmol/L

Accepted Answer

In chronic respiratory acidosis, for every 10mmHg rise in pCO2, the HCO3- typically rises by about 3-4 mmol/L, not 2 mmol/L.

Quiz 1: Electrolyte Imbalances and Acid-Base Disorders

Which is incorrect with regards to the fluid and its content?

Which is not a possibility in the ECG of a pt with hypokalemia?

Which is not a cause of hypokalemia?

Which of the drugs below are not associated with hypokalemia?

Which contains the largest amount of K+?

A rise in the pH by 0.1 causes what decrease in serum K+?

Which does not shift K+ into cells?

What is seen earliest in an ECG of hyperkalemia?

To diagnose SIADH as the cause of hyponatremia which must not be present?

which statement is incorrect?

Which neoplasm is not characteristically associated with SIADH?

Which drug is not well known to cause hyponatremia?

With regards to hypernatremia which is incorrect?

w.th regards to Calcium which statement is incorrect?

What is not a cause of hypercalcemia?

Which is incorrect with regards to hypocalcemia?

Which is not true of hypomagnasemia?

Which is not true with regards to hypermagnesemia?

Which equation is incorrect?

Which statement is incorrect?