Which of the following people would be most severely affected by prolonged vomiting?



a. 3-year-old male

b. 15-year-old male

c. 35-year-old male

d. 35-year-old female

e. 50-year-old male
3-year-old male

Extracellular fluid has a higher sodium content than intracellular fluid.

The predominant intracellular cation is potassium. The predominant extracellular cation is sodium Which of the following fluid compartments contains the largest volume of water?



a. plasma

b. interstitial compartment

c. intracellular compartment

d. extracellular compartment

e. lymph intracellular compartment

Water moves back and forth across the plasma membrane by the process of osmosis One difference between the plasma and interstitial fluid is that the plasma has significantly more _____ than interstitial fluid. protein The distribution of sodium and potassium ions between intracellular and extracellular compartments is



a. potassium mainly intracellular; sodium mainly in extracellular.

b. sodium mainly intracellular; potassium mainly in extracellular.

c. little of either intracellular but large amounts of both extracellular.

d. equal amounts of both ions, in both intracellular and extracellular fluids.

e. none of the above potassium mainly intracellular; sodium mainly in extracellular.

Which of the following individuals would have the largest percentage of their bodyweight as water?



a. a small 7-year-old female

b. a lean 35-year-old male athlete

c. a chunky 52-year-old male athlete

d. a healthy 88-year-old male

e. an adult female marathon runner a small 7-year-old female

Which of the following fluid compartments contains the smallest volume of water?



a. plasma

b. interstitial compartment

c. intracellular compartment

d. extracellular compartment

e. cytoplasm plasma Synovial fluid is a part of which of the following fluid compartments?

a. plasma

b. interstitial

c. intracellular

d. extracellular

e. cytoplasm extracellular This condition occurs when too much water and solute are taken in at the same time. Although extracellular fluid volume increases, plasma osmolarity may remain normal. hypervolemia Water output totals ____________ per day.
2500 ml

This condition occurs when water and solutes are lost at the same time. This condition primarily involves a loss of plasma volume. Plasma osmolarity usually remains normal even though volume is low. hypovolemia Water intake totals ____________ per day.
2500 ml

How many liters of water does the average adult body contain?
40 liters

Water output includes "insensible loss" fromskin, lungs and GI of ________per day.
1000 ml

This condition occurs when too much water is taken in without solute. Volume increases, but because solute is not present, plasma osmolarity decreases. overhydration This condition occurs when water, but not solute, is lost. It involves a loss of volume but, because solutes are not lost in the same proportion, plasma osmolarity increases. dehydration Water output through urine totals of ________per day.
1500 ml

Water intake includes ____________ from food and beverages and 200 mls from cell metabolism.
2300 ml

Antidiuretic hormone (ADH) increases water reabsorption in the kidneys.

Intense sympathetic stimulation of the kidney decreases renal flow.

Autoregulation in the kidney involves changes in the degree of constriction of afferent arterioles.

When aldosterone is absent, sodium reabsorption in the nephron is greatly decreased

Thirst is stimulated by

a. increased osmolality of the blood.

b. decreased blood volume.

c. increased angiotensin II.

d. all of these all of these

Renin is released by the
Kidney

Which ions are most important for establishing the resting membrane potential (RMP)?



a. Ca2+ ions

b. Cl- ions

c. K+ ions

d. Mg2+ ions

e. Na+ ions
K+ ions

Which of these normally represents the SMALLEST source of water loss from the body?

a. evaporation

b. feces

c. sensible and insensible perspiration

d. urine feces Which of the following events occurs last?
a. release of renin by the kidney

b. release of aldosterone by the adrenal cortex

c. sodium reabsorption by the kidney tubules

d. angiotensinogen ® angiotensin I

e. angiotensin I ® angiotensin II sodium reabsorption by the kidney tubules

As the rate of sweat production increases, the amount of sodium lost in the urine decreased You've been working outside in the hot sun and are dripping wet with sweat. Your fluid intake has been minimal as you have been too busy to stop and get a drink. You would expect



a. your blood osmolality to be low.

b. an increase in the production of urine.

c. aldosterone levels to decrease.

d. ADH levels to increase.

e. ADH levels to decrease.
ADH levels to increase.

Aldosterone secretion may be stimulated by elevated potassium levels.

Put the following in the correct order after the blood pressure increases.
1. decreased sympathetic stimulation
2. increase in glomerulus filtration rate
3. increase in arterial blood pressure
4. increase in urine production
5. afferent arterioles dilate
3, 1, 5, 2, 4
In the presence of liver disease, the synthesis of plasma proteins, including albumin, decreases. What effect will this have on the body?
a. The colloid osmotic pressure will decrease because there is less protein.

b. Because protein synthesis is decreased, plasma colloid osmotic pressure decreases. While fluid moves out of the plasma into the interstitial compartment, less fluid moves into the plasma from the interstitial compartment, resulting in fluid accumulation in the interstitial compartment.

c. Generalized edema will cause a drop in blood volume along with blood pressure. Increased fluid volume in the interstitial compartment impinges on the capillaries, restricting blood flow.

d. All are true all are true

The increased blood pressure associated with hypertension increases the _________________ in the capillaries, forcing fluid into the interstitial compartment, leading to edema. hydrostatic pressure

Which of the following would be expected to cause hyponatremia?

a. high intake of sodium

b. increased aldosterone production

c. increased urine output

d. increased ADH production

e. decreased ADH production increased ADH production

Cause of edema include



a. Decreased colloid osmotic pressure

b. Lymphatic obstruction

c. Increased hydrostatic pressure

d. Increased capillary permeability

e. all are causes of edema all are causes of edema

The major route of excretion for sodium ions (under normal conditions) is the kidney Obstruction of the lymphatic capillaries, which can occur with surgical removal of lymph nodes, causing ____________ to accumulate, leading to edema. interstitial fluid that is trapped

Serum electrolyte concentrations are most often expressed as mEq/L. Oversecretion of aldosterone causes increased secretion of potassium by the kidney

As a result of injury or inflammation, increased ___________________in the area of injury allow proteins, followed by water, to move more freely into the interstitial compartment, causes edema. capillary permeability

Which of the following statements concerning potassium ions is false?
a. An increase in the extracellular potassium ion concentration leads to depolarization.

b. Potassium ions are secreted into the nephron by the distal convoluted tubule.

c. When aldosterone levels are high, potassium secretion is low.

d. Aldosterone secretion is stimulated by high blood levels of potassium ions.

e. none of the above are false
When aldosterone levels are high, potassium secretion is low.

The most common cause of hyperkalemia is cellular injury or death.

Which of the following will the body begin to do in order to compensate for hyperkalemia?



a. vasoconstriction of blood vessels

b. increase ADH secretion

c. decrease aldosterone secretion

d. increase the release of atrial natriuretic hormone

e. increase aldosterone secretion increase aldosterone secretion

Decreased extracellular potassium levels cause hyperpolarization of cell membranes.

Hyperkalemia is defined as increase in plasma potassium level.

Oversecretion of aldosterone causes hypernatremia Potassium levels in the body are regulated by aldosterone Aldosterone secretion may be stimulated by elevated potassium levels.

Calcitonin reduces extracellular calcium ion levels.

An increase in parathyroid hormone levels results in increased rate of bone resorption.

Most of the calcium in the body is in the bones \

The main regulator of serum phosphate levels is a transport process in the kidneys Calcium's roles in the body include
a. bone health.

b. muscle contraction.

c. blood clotting.

d. action potentials in heart muscle.

e. all of the above all of the above

Stimulus for the secretion of parathyroid hormone is a decrease in serum calcuim levels

A major complication of thyroid surgery is the accidental damaging or removal of the parathyroid glands. This damage or removal of the parathyroid glands can result in decreased plasma calcium.

In hypocalcemia, neuromuscular excitability increases.

Adequate calcium absorption from the GI tract depends on adequate amounts of vitamin D

Calcium balance is influenced by parathyroid hormone and vitamin D levels.

pH is a measure of the hydrogen ion concentration.

Which of the following substances releases hydrogen ions into a solution?



a. acids

b. bases

c. salts

d. glucose

e. water acids An acid
a. has a pH below 7.

b. that completely dissociates in solution is a strong acid.

c. releases hydrogen ions into a solution.

d. is a compound such as H2CO3.

e. all of these all of these

Which of these is NOT one of the major buffer systems in the body?



a. lactic acid buffer system

b. carbonic acid/bicarbonate buffer system

c. phosphate buffer system

d. protein buffer system lactic acid buffer system

Which of the following is not a buffer system of the body?
a. bicarbonate buffer system

b. phosphate buffer system

c. protein buffer system

d. NaCl buffer system

e. hemoglobin buffer
NaCl buffer system

Buffers
a. bind to excess H+ ions that are added to a solution.

b. prevent large changes in body fluid pH.

c. may involve weak acids.

d. release H+ ions when H+ ion concentration in a solution falls.

e. all of these all of these

The normal pH for blood plasma is
7.40

Chemicals that function to minimize changes in the pH of body fluids are called
a. buffers.

b. inhibitors.

c. accelerators.

d. activators.

e. stabilizers. buffers When hydrogen ions are secreted into the lumen of the nephron, sodium ions and __________ pass into the extracellular fluid. bicarbonate ions

Nephrons directly regulate acid-base balance by secreting H+ ions into the filtrate.

Which of the following is correctly matched?



a. alkalosis - hypokalemia

b. cell destruction - hypokalemia

c. increased secretion of aldosterone - hyperkalemia

d. overuse of diuretics - hyperkalemia

e. acidosis - hypokalemia alkalosis - hypokalemia

The reaction between CO2 and H2O is catalyzed by carbonic anhydrase.

In renal compensation of acidosis,
H+ secretion increases; bicarbonate reabsorption increases.

If the hydrogen ion concentration in the blood increases, bicarbonate ions act as buffers by removing excess hydrogen ions from the plasma

When normal buffer mechanisms are overwhelmed by excessive numbers of hydrogen ions, which of the following will result? acidiosis The major effect of acidosis is the __________ of the nervous system, whereas a major effect of alkalosis is __________ of the nervous system. hyperexcitability, depression

An increase in blood CO2 levels is followed by a(n) ____ in H+ ions and a(n) ____ in blood pH. increase, decrease

Decreased elimination of CO2 from the body causes pH to __________ and can result in __________ . decrease, acidosis.

Which of these normally represents the SMALLEST source of water loss from the body?



a. evaporation

b. feces

c. sensible and insensible perspiration

d. urine feces Which acid base imbalance is most likely to occur as a result of hypoventilation?



a. respiratory acidosis

b. respiratory alkalosis

c. metabolic acidosis

d. metabolic alkalosis respiratory acidosis

Respiratory alkalosis can occur as a result of hyperventilation Which acid base imbalance is most likely to occur as a result of an asthma attack? respiratory acidosis

Ingesting large amounts of sodium bicarbonate can lead to metabolic alkalosis.

Bob Trotts has an enteropathogenic E. coli infection resulting in severe diarrhea for 2 days. This could produce which of the following.
1. acidosis
2. alkalosis
3. increased respiration
4. decreased respiration
5. increased ADH secretion
6. increased renin secretion
7. increased urine concentration
1, 3, 5, 6, 7

Which acid base imbalance is most likely to occur as a result of hyperventilation?
a. respiratory acidosis

b. respiratory alkalosis

c. metabolic acidosis

d. metabolic alkalosis respiratory alkalosis

A falling blood pH and a rising concentration of carbon dioxide due to emphysema, indicate respiratory acidosis.

Which acid base imbalance is most likely to occur as a result of untreated diabetes mellitus?



a. respiratory acidosis

b. respiratory alkalosis

c. metabolic acidosis

d. metabolic alkalosis metabolic acidosis

Mr. I.M.A. Wreck's plasma pH is 7.2. Which of the following indicates that the body is attempting to compensate and return the body pH to normal?
a. an increase in respiration rate

b. no change in respiration rate

c. a decrease in respiration rate an increase in respiration rate

Prolonged vomiting of stomach contents will result in metabolic alkalosis.

Which acid base imbalance is most likely to occur as a result of prolonged diarrhea resulting in excessive loss of bicarbonate?

a. respiratory acidosis

b. respiratory alkalosis

c. metabolic acidosis

d. metabolic alkalosis metabolic acidosis

Which acid base imbalance is most likely to occur as a result of excessive intake of antiacids?



a. respiratory acidosis

b. respiratory alkalosis

c. metabolic acidosis

d. metabolic alkalosis metabolic alkalosis

Azetazolamide (Diamox) is a diuretic. It functions by blocking the activity of carbonic anhydrase inside kidney tubule cells. This slows the formation of carbonic acid. By slowing the formation of hydrogen ions in the cells of the tubule, sodium reabsorption is also slowed. This results in the diuretic effect. Select from the following list the possible side-effects of Azetazolamide.
1. acidosis
2. reduced movement of bicarbonate ion into the plasma
3. an alkaline urine is produced
4. respiration increases
1, 2, 3, 4

Discuss the three ways the body compensates for acidosis and alkalosis.
Compensation for Acidosis and AlkalosisThe body compensates for acidosis and alkalosis with three major mechanisms:• Chemical buffers• Respiratory system• Urinary System• Chemical buffers work quickly and immediately, but they have a limited capacity. When the buffer systems become overwhelmed, as in acidosis or alkalosis, the respiratory and urinary systems compensate. • Note that compensatory mechanisms help return the pH to normal or near normal levels, but do not correct the underlying problem.• When metabolic acidosis or alkalosis occurs, the respiratory system will compensate by changing the rate of respiration. • When respiratory acidosis or alkalosis occurs, the problem lies within the respiratory system. Because the respiratory system is not able to correct the condition, the urinary system compensates for the problem.