Regarding body water …….all are true except

1.   ?    in a healthy 65 Kg male …it is about 40 Liters in amount
2.   ?    70 % of total body water is intracellular
3.   ?    70 % of extra cellular water is in the interstitium
4.   ?    water moves between different body compartments by an active process
5.   ?    whole body extra cellular water is about 12 liters

All of the followings are true …except

1.   ?    the tonicity of plasma and interstitial fluids is determined by the concentration of sodium and chloride
2.   ?    the tonicity of intracellular fluid is determined by the concentration of potassium, magnesium, phosphate and sulphate
3.   ?    the amount of hydrogen ion in the extra cellular fluid is tiny (about 40nmol/liter)
4.   ?    Much of the extra cellular hydrogen ions can be buffered by anionic proteins like albumin and hemoglobin
5.   ?    the difference in the ionic composition of cells and interstitial fluid is important for the normal cell function

Factors increasing potassium excretion ……all are true except

1.   ?    avid sodium re-absorption
2.   ?    high urinary flow rate
3.   ?    excess poorly absorbed anions...like ketons and phosphates
4.   ?    a rise in intra tubular potassium e.g. alkalosis
5.   ?    a fall in intracellular potassium e.g. acidosis

In the proximal convoluted tubules…..all are true except

1.   ?    90% of the filtered sodium is reabsorbed
2.   ?    80-90% of the filtered potassium is reabsorbed
3.   ?    90% of the filtered bicarbonate is reabsorbed
4.   ?    99% of the filtered glucose is reabsorbed
5.   ?    99% of the filtered amino acids are reabsorbed

Regulation of water excretion …..All are true except

1.   ?    in the presence of ADH, the collecting duct becomes permeable to water
2.   ?    in the absence of ADH, the distal nephron is almost impermeable to water
3.   ?    about 90% of the filtered water is reabsorbed with an equivalent amount of sodium in the proximal tubule
4.   ?    ADH binds to V2 receptors in the distal nephron to enhance the passive movement of water.
5.   ?    in the thick ascending limb of loop of Henle, sodium and chloride are preferably absorbed without water and hence called the Diluting segment.

Drugs which cause sodium retention

1.   ?    corticosteroids
2.   ?    liquorice
3.   ?    carbenoxolone
4.   ?    Estrogens
5.   ?    ethacrynic acid

Causes of diuretic resistance …all are true except

1.   ?    profound hypoproteinemia
2.   ?    volume contraction
3.   ?    reduced renal function
4.   ?    secondary aldoseronism
5.   ?    when given in low doses

Etiology of hyponatraemia associated with LOW extra cellular fluid volume …..All are true except

1.   ?    salt losing renal disease
2.   ?    adrenal failure
3.   ?    liver cirrhosis
4.   ?    extensive burns
5.   ?    cardiac failure

Causes of SIADH ….all are true…except

1.   ?    morphin
2.   ?    smoking
3.   ?    alcohol
4.   ?    amitryptilin
5.   ?    clofibrate

The following lab findings are consistent with SIADH...Except

1.   ?    palsma osmolality 260 mosm / Kg
2.   ?    serum sodium 115 mmol / L
3.   ?    urine osmolality 200 mosm / Kg
4.   ?    blood urea 2.5 mmo l/ L
5.   ?    plasma potassium 4 mmol / L

Drug induced hyperkalemnia

1.   ?    digoxin toxicity
2.   ?    ciclosporin
3.   ?    heparin
4.   ?    beta agonists
5.   ?    ACE inhibitors

The followings are true regarding the treatment of hyperkalemia...Except

1.   ?    bicarbonate infusion reduces serum potassium by 1-1.5 meq/L
2.   ?    glucose and insulin infusion policy reduces serum potassium by 0.6-1.2 meq / L
3.   ?    calicium gluconate infusion does not reduce serum potassium
4.   ?    calcium resonium is not used in acute hyperkalemia treatment
5.   ?    beta agonists' infusion may be additive or alternative to glucose and insulin policy

Complications of severe hypophosphatemia …all are true …except

1.   ?    increased CPK
2.   ?    respiratiry muscle weakness
3.   ?    intrasvascular hemolysis
4.   ?    hypocalciuria
5.   ?    cardiac dysrrhythmias

Causes of hypophsphatemia …….all are true except

1.   ?    chronic alcoholism
2.   ?    alcohol withdrawal
3.   ?    peritoineal dialysis
4.   ?    hemodialysis
5.   ?    extra cellular fluid contraction

Causes of hypomagnesemia …..All are true …except

1.   ?    Gitelman syndrome
2.   ?    post obstructive diuresis
3.   ?    acute pancreatitis
4.   ?    protracted vomiting
5.   ?    treatment with spironolactone

Causes of normal anion gap metabolic acidosis …all are true except

1.   ?    treatment of glaucoma
2.   ?    after radical surgery of urinary bladder cancer
3.   ?    ingestion of arginin hydrochloride
4.   ?    renal tubular acidosis type IV
5.   ?    diabetic ketoacidosis

Causes of High anion Gap metabolic acidosis with their accumulating compounds ….…..all are true...Except

1.   ?    methanol poisoning- formic acid
2.   ?    lactic acidosis- lactic acid
3.   ?    ketoacidosis- acetoacetic acid and beta hydroxybutyrate
4.   ?    ethylene glycol poisoning – formic acid
5.   ?    chronic renal failure – phosphoric acid and sulphuric acid

Causes of lactic acidosis type A …all are true except

1.   ?    septic shock
2.   ?    severe anemia
3.   ?    metformin
4.   ?    cyanide poisoning
5.   ?    respiratory failure

About causes of respiratory alkalosis ; all are true except

1.   ?    assited ventilation
2.   ?    salysylate poisoning
3.   ?    hysterical over breathing
4.   ?    lobar pneumonia
5.   ?    protracted vomiting