Quiz
Acid Base (Module)
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170mmol of H+ is produced daily from cellular metabolism and from the proteins that we eat. How does the body handle the addition of these protons in order to maintain extracellular pH at 7.4?
- A70mmol of H+ is lost via respiration
- B70mmol of H+ is excreted by the kidney
- C70mmol of bicarbonate is produced to make 70mmol each of CO2 and H2O
2which is the correct formula of the Henderson Hasselbach equation?
- A[H+] = k' [HA]/[A-]
- BpH = pK + log [A-]/[HA]
- CpH = pK + log [HA]/[A-]
- DpK = pH + log [A-]/[HA]
- EpK = pH + log [HA]/[A-]
3In a graph of pH vs [H+] in nmol/L, the relationship is almost linear between pH 7.30 and 7.50 with a slope of -1
- ARichtig
- BFalsch
4The normal range for pH in the ECF is between
- A7.45 and 7.35
- B7.35 and 7.25
- C7.45 and 7.25
- D7.55 and 7.45
- E7.55 and 7.25
5The main buffer of the ECF is
- Abicarbonate/ carbonic acid
- BHemoglobin and proteins
- CPhosphate/ organic acids
6the main buffer in ICF is
- Abicarbonate/ carbonic acid
- Bhemoglobin and proteins
- Cphosphate/ organic acids
7the main buffer in urine is
- Aphosphate/ organic acids
- Bbicarbonate/ carbonic acids
- Chemoglobin and proteins
8A decrease in pH
- Astimulates ventilation and decreases PCO2
- Binhibits ventilation and increase PCO2
9An increase in pH
- Astimulates ventilation and decreases PCO2
- Binhibits ventilation and increases PCO2
- Cstimulates ventilation and increases PCO2
- Dinhibits ventilation and decreases PCO2
10What effect does aldosterone have on protons?
- AStimulates H+ secretion into the CD
- BStimulates H+ reabsorption from the CD
- CNothing
11A PCO2 increases, [blank_start]reabsorption[blank_end] increases
- Areabsorption
- Bsecretion
- Csynthesis
12The most important determinant of HCO3- reabsorption is
- Aa rise in PCO2
- BAldosterone secretion
- Cincrease in delivery of HCO3- in the PT
- DIncrease in amount of HCO3- filtered
- EClinical being hypovolemic.
13How does the pH decrease from the loop of Henle to the collecting duct?
- Aalpha intercalated cells secrete H+ via the H+ATPase
- BThere is passive diffusion of H+ ions down their concentration gradient
- CThe H+/ Na exchanger in the principal cell takes up Na while leaving H+ in the lumen
14Where is bicarbonate produced?
- AAbsorbed from the gut only
- Bthe liver
- Cin the lungs
- Dby the kidney
15The barrier in the CD that prevents H+ from returning to the blood enables the lumen pH to stay markedly low and facilitates the formation of
- Abicarbonate and carbonic acid
- Btitratable acid and ammonium
- CUrea and uric acid
16in titratable acid formation, what is the most important anion and what is the product?
- AHPO4 (2-) and a new HCO3-
- BHCO3- and H2PO4-
- CHPO4 (2-) and H2O and CO2
17Secretion of ammonium
- Aregenerates a new bicarbonate molecule
- Bresults in no net gain of bicarbonate
18The anion gap is the difference between unmeasured anions and unmeasured cations
- ARichtig
- BFalsch
19Under normal conditions, how much does albumin contribute to the unmeasured anions?
- A>70%
- B70%
- CBetween 35 and 70%
- D<35%
20in a metabolic acidosis the primary disturbance is caused by
- Aan increase in HCO3-
- Ban increase in PCO2
- Ca decrease in HCO3-
- Da decrease in PCO2
21The secondary response in a metabolic acidosis can be approximated by
- A40-1.2 x [HCO3-]
- B40- 0.7 [HCO3-]
- C40+1.2 x [HCO3-]
- D40+ 0.7 [HCO3-]
22Diarrhea can cause hyperchloremia because
- AECF, Na+ and K+ are lost to a greater degree than chloride is lost, therefore the same amount of chloride in a smaller volume results in hyperchloremia
- BThe loss of Na+ and H+ results in more reabsorption of Cl- in the kidney
- CHCl is titrated with HCO3- and produces H2CO3 and Cl- that results in hyperchloremia
23Increased anion gap acidosis occurs when an exogenous acid is added to the system accompanied by an anion that is not chloride.
- ARichtig
- BFalsch
24metabolic acidosis is caused by
- Aan increase in pH because there has been a decrease in [HCO3-]
- Ban increase in pH because there has been a increase in [HCO3-]
- Can decrease in pH because there has been a decrease in [HCO3-]
- Dan decrease in pH because there has been a increase in [HCO3-]
25an appropriate secondary response in metabolic alkalosis can be approximated by the PCO2 when
- A40 + 0.7 x [HCO3-]
- B40 - 0.7 x [HCO3-]
- C40 + 1.2 x [HCO3-]
- D40 - 1.2 x [HCO3-]
26The etiology of metabolic alkalosis can occur by
- Aingesting of large amounts of NaHCO3 or CaCO3 by a person with renal impairment
- Bingesting large quantities of methanol, ethylene glycol and aspirin
- Ccentral nervous system depression
- Dspending too much time at high altitudes
- Epregnancy
27vomiting can lead to loss of hydrogen and chloride ions that results with [blank_start]K+[blank_end] loss from secondary stimulation of ENaC
- AK+
- BNa+
- CHCO3-
- DCl-
- EH+
28Select the most correct answer regarding the pendrin (HCO3-/Cl-) exchanger:
- ACl- is secreted into the lumen (urinary space) and HCO3- is reabsorbed from the lumen to the blood; stimulated by alkalosis
- BCl- is secreted into the lumen (urinary space) and HCO3- is reabsorbed from the lumen to the blood; stimulated by acidosis
- CHCO3- is secreted into the lumen (urinary space) and Cl- is reabsorbed from the lumen to the blood; stimulated by alkalosis
- DHCO3- is secreted into the lumen (urinary space) and Cl- is reabsorbed from the lumen to the blood; stimulated by acidosis
29Select the 4 factors below that limit kidney excretion of excess bicarbonate
- Ainadequate kidney function
- Black of available chloride
- Ctoo much chloride
- Dhypokalemia
- Ehyperkalemia
- Fstimulation of ENaC
- Ginhibition of ENaC
30A urine alkaline tide created by stimulating the pendrin exchanger initially attempts to correct a metabolic alkalosis after vomiting (or nasogastric drainage) but the subsequent increased activity of ENaC sustains the alkalosis
- ARichtig
- BFalsch
31loop diuretics and thiazides can cause metabolic acidosis because there is a 1:1 los of Na+ and HCO3-
- ARichtig
- BFalsch
32the alkalemia in chloride depleted states is worsened by the accompanying hyperkalemia
- ARichtig
- BFalsch
33The real pathogenesis of sustained metabolic alkalosis is an interaction between chloride depletion, potassium depletion and secondary stimulation of the ENaC that allows the increase in ECF [blank_start]bicarbonate[blank_end] to be sustained.
- AHCO3-
- BH+
- CCl-
- DK+
- Eunmeasured anions
- FNa+
34Mineralocorticoid excess leads to [blank_start]primary[blank_end] stimulation of ENaC that results in on going losses of H+ and K+
- Aprimary
- Bsecondary
- Cdecreased
35Hyperaldosteronism causes
- Aan increase in the Na+/K+ ATPase thingyabobber and an increase in the H+ATPase thingyabobber that results in more Na+ reabsorption and H+ secretion
- Ba decrease in the Na+/K+ ATPase thingyabobber and an increase in the H+ATPase thingyabobber that results in more Na+ reabsorption and H+ secretion
- Ca decrease in the Na+/K+ ATPase thingyabobber and a decrease in the H+ATPase thingyabobber that results in more Na+ reabsorption and H+ secretion
36Metabolic alkalosis can be divided pathophysiologically into three categories - chose the correct ones
- ACl- depletion syndromes associated with K+ losses and secondary stimulation of ENaC
- BPrimary stimulation of collecting duct sodium uptake via ENaC
- Calkali administration in the setting of kidney failure or very low dietary Cl- intake.
- Dalkali administration in the setting of kidney failure or very high dietary Cl- intake.
- EPrimary stimulation of Cl- uptake in the loop of Henle via the Na/Cl-/K+ triple transporter
- FK+ depletion syndromes associated with Cl- losses and secondary stimulation of ENaC
37Select from the list below the 5 non-renal causes of Cl- losses
- Avomiting
- BNG drainage
- Ccongenital chloridorrhea
- Dhigh volume ileostomy drainage
- Esome villous adenomas
- Fmineralocorticoid excess syndrome
- Ghyperaldosteronism
- Hcongenital adrenal hyperplasia
- I11-beta-OH-steroid dehydrogenase deficiency
- JLiddle syndrome
38from the list below, select the 4 causes of RENAL Cl- loss:
- ALiddle syndrome
- BBartter syndrome
- CGitelman syndrome
- DK+ depletion
- EChloruretic diuretics
- FCongenital chloridorrhea
- G11 beta OH-steroid dehydrogenase deficiency
39vomiting, NG drainage and chloruretic diuretics are responsible for 98% of metabolic alkalosis
- ARichtig
- BFalsch
40Select the (5)alkalosis conditions below that would correct with administration of chloride
- Avomiting
- BNG drainage
- Cafter thiazide or loop diuretic use
- Dpost hypercapnia
- Elaxative abuse (Cl- depleting diarrhea)
- FBartter syndrome
- GGitelman syndrome
- Hhyperaldosteronism
- Isyndrome of apparent mineralocorticoid excess
- JLiddle syndrome
Informationen
- Beschreibung
- Quiz am Acid Base (Module) , erstellt von heckmoto am 26/10/2015.
- Autor
- heckmoto
- Sprache
- English
- Aufrufe
- 0
- Verlauf
- Erstellt am 26 Okt 2015 · aktualisiert am 19 Feb 2016
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