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 |
Answer» C. Hartmans –131mmolCl-/L |
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 |
Answer» D. Prolonged QT interval |
3. |
Which is not a cause of hypokalemia? |
A. | insulin administration |
B. | adrenaline infusion |
C. | alkalosis |
D. | toluene toxicity |
E. | digoxin OD |
Answer» E. digoxin OD |
4. |
Which of the drugs below are not associated with hypokalemia? |
A. | loop diuretics |
B. | corticosteroids |
C. | gentamicin |
D. | amiloride |
E. | theophylline |
Answer» D. amiloride |
5. |
which of the following is not a symptom of hypokalemia? |
A. | ileus |
B. | constipation |
C. | muscle weakness |
D. | paralysis |
E. | seizures |
Answer» E. seizures |
6. |
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 |
Answer» B. 2 chlorvescent tablets |
7. |
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 |
Answer» C. 0.5mEq/L |
8. |
Which does not shift K+ into cells? |
A. | insulin |
B. | dextrose |
C. | NaHCO3 |
D. | Salbutamol |
E. | resonium |
Answer» E. resonium |
9. |
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 |
Answer» B. Peak T wave |
10. |
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 |
Answer» A. hypovolemia |
11. |
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 |
Answer» E. central pontine myelinolysis is caused when hypernatremia is corrected to quickly |
12. |
Which neoplasm is not characteristically associated with SIADH? |
A. | mesothelioma |
B. | bronchogenic carcinoma |
C. | breast |
D. | prostate |
E. | bladder |
Answer» C. breast |
13. |
Which drug is not well known to cause hyponatremia? |
A. | sertraline |
B. | amitryptilline |
C. | ecstasy |
D. | carbamazepine |
E. | roxithromycin |
Answer» E. roxithromycin |
14. |
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 |
Answer» C. Normal Saline should not be used if the pt is hypovolemic and hypotensive |
15. |
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 |
Answer» E. calcium chloride has less elememtal calcium than calcium gluconate |
16. |
What is not a cause of hypercalcemia? |
A. | post prandial measurement |
B. | tuberculosis |
C. | lung Ca |
D. | hypomagnasemia |
E. | renal failure |
Answer» D. hypomagnasemia |
17. |
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 |
Answer» E. hyperventilation produces tetany by causes a fall in the total body calcium |
18. |
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 |
Answer» B. it causes pre eclampsia |
19. |
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 |
Answer» C. it causes hypocalcemia |
20. |
Which equation is incorrect? |
A. | anion gap =(Na+ + K+) - (Cl- + HCO3-) |
B. | calculated serum osmolality = 2(Na + urea +glucose) |
C. | paO2 = pIO2 – paCO2/0.8 |
D. | the expected CO2 in metabolic acidosis = 1.5 × HCO3- + 8 |
E. | the expected CO2 in metabolic alkalosis =0.9× HCO3- + 9 |
Answer» B. calculated serum osmolality = 2(Na + urea +glucose) |
21. |
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 |
Answer» E. in chronic respiratory acidosis, for every 10mmHg rise in pCO2 ,the HCO3 rises 2mmol/L |
22. |
which does not cause a high osmolar gap, increased anion gap metabolic acidosis? |
A. | methanol |
B. | ethanol |
C. | ethylene glycol |
D. | acetone |
E. | chloral hydrate |
Answer» E. chloral hydrate |
23. |
Which agent below does no cause an increased anion gap metabolic acidosis? |
A. | acetzolamide |
B. | paraldehyde |
C. | iron |
D. | aspirin |
E. | carbon monoxide inhalation |
Answer» A. acetzolamide |
24. |
Which condition can be fully compensated for with regards to pH? |
A. | respiratory acidosis |
B. | respiratory alkalosis |
C. | metabolic acidosis |
D. | metabolic alkalosis |
E. | none of the above |
Answer» B. respiratory alkalosis |
25. |
Which does not cause a metabolic alkalosis? |
A. | vomiting |
B. | diarrohea |
C. | loop diuretics |
D. | thiazide diuretics |
E. | corticosteroids |
Answer» B. diarrohea |
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