Matary MCQ Water and Electrolytes 2013-2014

Water &
electrolytes
MCQ
What is the percentage of water in a healthy adult?
A. 30 - 40% of body weight.

B. 45 - 65% of body weight.
C. 70 - 80% of body weight.
D. 15 - 20%.
Which one of the following has maximum amount
of water in the body?
A. Intracellular fluid.
B. Interstitial fluid.
C. Plasma.
D. Central spinal fluid.
Which one of the following is the predominant
cation in intracellular fluid?
A.Chloride.
B.Calcium.
C.Sodium
D.Potassium
Which is the predominant cation in the
extracellular fluid?
A. Sodium.
B. Magnesium.
C. Calcium.
D. Potassium.
Which one of the below presents with decreased
deep tendon reflexes?
A.Hypomagnesaemia.
B.Hypocalcaemia.
C.Hypoglycemia.
D.Hypokalemia.
What are the ECG changes expected to be seen in
patients with hyperkalemia?
A. Prolonged PR interval.
B. Atrial fibrillation.
C. Peaked T waves.
D. Inverted T wave.
Hypomagnesaemia resembles the clinical of which one
of the following?
A. Hypokalemia.
B. Hyperphosphatemia.
C. Hyperglycemia.
D. Hypocalcemia.
What is the treatment of choice for a patient who
has potassium level of 6.5mmol/L and ECG
changes of hyperkalemia?
A. Calcium gluconate.
B. Lactated Ringer.
C. Insulin and glucose.
D. Kayexalate (cation exchange resin).
What is the basal daily required amount of water
for adults?
A. 10 ml/kg.
B. 15 ml/kg.
C. 35 ml/kg.
D. 55 ml/kg.
E. 75 ml/kg.
Regarding hypokalemia, all the following
statements are true, except:
A. Serum potassium of 2.5 mmol/L is Hypokalemia

B. Hypokalemia causes acidosis.
C. Severe diarrhea may cause Hypokalemia.
D. Hypokalemia causes muscle weakness.
E. Hypokalemia causes paralytic ileus.
About metabolic acidosis, one statement only is
true:
A. It is caused by pyloric stenosis.

B. It causes hyperkalemia.
C. Arterial bicarbonate level is elevated.
D. pH is above 7.4.
E. Respiratory rate is reduced.
A 34 year old male , a known case of
ulcerative colitis , presented to the
emergency room with severe diarrhea,
weakness, and his ECG showed prolongation
of the QT wave. This patient is suffering
mainly from:
A- Hyponatremia.
B- Hypokalemia.
C- Metabolic alkalosis.
D- Respiratory acidosis.
13 P.K
Causes of metabolic acidosis includes all of the following
except:
a. Sepsis.
b. Large volume of saline resuscitation.
c. Advanced renal failure.
d. Advanced distension.
14 P.K
Sodium is considered to be the main:
a. Extracellular anion.
b. Intracellular anion.
c. Extracellular cation.
d. Intracellular cation.
15 P.K
The main causes of hypokalemia includes all of the
following except:
a. Excessive vomiting.
b. Diarrhea. .
c. External alimentary fistulas.
d. Acidosis.
16 P.K
What is the amount of body water in a full term
healthy neonate?
A. 55 ml/kg.
B. 80 ml/kg.
C. 90 ml/kg.
D. 110 ml/kg.
Metabolic acidosis with a normal anion gap (AG)
occurs with :
a. Diabetic acidosis.
b. Renal failure.
c. Severe diarrhea.
d. Starvation.
Serum sodium of 129 seen in the immediate
postoperative period:
a. Warrants aggressive treatment with hypertonic

saline to prevent seizures.
b. Should be treated with boluses of 0.9% NaCI until
corrected.
c. Is a self-limiting problem due to transient increase
in antidiuretic hormone secretion.
d. Is due to excessive fluids given intra-operatively.
Which of the following is an early sign of
hyperkalemia?
a. Peaked T waves.
b. Peaked P waves.
c. Wide QRS complex.
d. Peaked U waves.
The next most appropriate test to order in a patient
with a pH of 7.1, PCO2 of 40, sodium of 132, a
potassium of 4.2, and a chloride of 105 is:
a. Serum bicarbonate.
b. Serum magnesium.
c. Serum ethanol.
d. Serum salicylate.
Normal saline is :
a. 135mEq NaCI/L.
b. 145 mEq NaCI/L.
c. 148mEq NaCI/L
d. 154mEq NaCI/L.
Water constitutes what percentage of total body
weight?
a. 30 - 40%.
b. 40 - 50%.
c. 50 - 60%.
d. 60 - 70%.
A patient who has spasms in the hand when a
blood pressure cuff is blown up most likely has :
a. Hypercalcemia.
b. Hypocalcemia.
c. Hypermagnesemia.
d. Hypomagnesaemia.
Metabolic acidosis with a normal anion gap is
found in a patient with :
a. Alcohol intoxication.
b. Aspirin ingestion.
c. Diabetic Ketoacidosis.
d. Small bowel fistula.
The effective osmotic pressure between the plasma
and interstitial fluid compartments is primarily
controlled by :
a. Bicarbonate.
b. Chloride ion.
c. Potassium ion.
d. Protein.
The most common fluid disorder in the surgical
patient is :
a. Extracellular fluid deficit.

b. Hyperkalemia.
c. Hyponatremia.
d. Metabolic acidosis.
e. Metabolic alkalosis.
Symptoms and signs of extracellular fluid
volume{shocked patient} deficit include all of the
following EXCEPT:
a. Anorexia.
b. Apathy.
c. Decreased body temperature.
d. High pulse pressure.
The osmolarity of the extracellular fluid space is
determined primarily by the concentration of:
a. Bicarbonate.
b. Chloride ion.
c. Phosphate radicals.
d. Sodium ion.
When lactic acid is produced in response to injury,
the body minimizes pH early by:
a. Decreasing production of sodium bicarbonate in

tissues.
b. Excreting carbon dioxide through the lungs.
c. Excreting lactic acid through the kidneys.
d. Metabolizing the lactic acid in the liver
The simplest effective method of estimating the
degree of acidosis in a patient in shock is the
measurement of:
a. Arterial pH.
b. End tidal CO2 concentration.
c. pH of mixed venous blood.
d. Serum CO2 level.
A decrease in intracellular water can be
precipitated by :
a. A decrease in sodium in extracellular fluid.

b. An increase in sodium in extracellular fluid.
c. An increase in sodium in intracellular fluid.
d. An isotonic decrease in extracellular fluid.
The first step in the management of acute
hypercalcemia should be :
a. Correction of deficit of extracellular fluid volume.

b. Hemodialysis.
c. Administration of furosemide.
d. Administration of vitamin D.
A primary action of aldosterone is to :
a. Convert angiotensinogen to angiotensin.

b. Decrease chloride reabsorption in the renal tubule.
c. Decrease potassium secretion in the renal tubule.
d. Increase sodium reabsorption in the renal tubule.
e. Increase rennin release by the juxtaglomerular
apparatus.
The normal serum electrolytes in mEq/L are as
follows except for:
a. Sodium : 135 -145.

b. Potassium : 3.5 - 4.5.
c. Calcium : 9 -11.
d. Chloride : 102 -105.
e. Bicarbonate : 23 - 27.
Hyponatremia may result from any of the following
except:
a. Adrenal insufficiency.
b. Cirrhosis of the liver.
c. Nephrotic syndrome.
d. Diabetes insipidus.
e. Diuretic abuse.
Which statement among the following is wrong
about hyperkalemia :
a. Results form renal failure, acidosis and over

treatment with potassium salts.
b. Causes tachycardia.
c. May produce cerebral symptoms.
d. Causes peaking of the T-waves in the ECG.
e. May cause cardiac arrest.
Acidosis may be produced by the following except:
a. Prolonged shock.
b. Hypoventilation.
c. Uncontrolled diabetes.
d. Open heart surgery.
e. Cirrhosis of the liver.
Concerning metabolic acidosis, which of the
following statements is untrue :
a. Occurs in diabetes, starvation, shock and anuria.

b. May be due to diarrhea and intestinal fistulas.
c. Is often associated with air hunger.
d. Causes bradycardia and hypotension.
e. Always follows cardiac arrest.
Metabolic acidosis can be seen with the following
except:
a. Septic peritonitis.
b. Septic shock.
c. Pyloric stenosis.
d. Diabetic coma.
The following electrolytes are significantly altered
by changes in pH except:
a. Sodium.
b. Potassium.
c. Calcium.
d. Magnesium
e. Chloride.
The earliest sign of hypocalcaemia is :
a. Carpopedal spasms.
b. Positive Chvosteks' sign.
c. Positive Trousseau's sign.
d. Tingling of fingers and circumoral region.
e. Defective blood coagulation.
A patient with pure metabolic acidosis can have all
of the following except:
a. A pH of 7.36.
b. A pO2 of 100 mmHg.
c. A pCO2 of 45 mmHg.
d. AHCO3 of 16 mmol/L.
The main role of the kidney in regulation of the
acid-base balance is by :
a. Reabsorbing the filtered bicarbonate.

b. Reabsorbing H+ ions.
c. Excreting bicarbonate.
d. All of the above.
e. None of the above.
The normal extracellular pH is :
a. 7.4 + 0.03.
b. 7.4 +/- 0.04.
c. 7.4 ± 0.05.
d. 7.4 ± 0.6.
The main treatment of respiratory acidosis is :
a. IV sodium bicarbonate 1mEq/kg body weight.

b. Improve the ventilation.
c. Sedation.
d. Re breathe in a bag.
The blood volume of the newborn is :
a. 20 – 40 ml/kg.
b. 40 – 60 ml/kg.
c. 80 – 85 ml/kg.
d. 100 – 120 ml/kg.

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Water &

A. 30 - 40% of body weight.

patients with hyperkalemia?

A. Serum potassium of 2.5 mmol/L is Hypokalemia

A. It is caused by pyloric stenosis.

a. Warrants aggressive treatment with hypertonic

a. Extracellular fluid deficit.

a. Decreasing production of sodium bicarbonate in

a. A decrease in sodium in extracellular fluid.

a. Correction of deficit of extracellular fluid volume.

a. Convert angiotensinogen to angiotensin.

a. Sodium : 135 -145.

a. Results form renal failure, acidosis and over

a. Occurs in diabetes, starvation, shock and anuria.

a. Reabsorbing the filtered bicarbonate.

a. IV sodium bicarbonate 1mEq/kg body weight.

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