| 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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