[MCQ] Hypernatremia

I. Start the exam by click the “Start” button

Hypokalemia

Please wait while the activity loads.
If this activity does not load, try refreshing your browser. Also, this page requires javascript. Please visit using a browser with javascript enabled.

If loading fails, click here to try again

Start

Congratulations - you have completed Hypokalemia. You scored %%SCORE%% out of %%TOTAL%%. Your performance has been rated as %%RATING%%

Your answers are highlighted below.

Question 1

Normal plasma potassium concentration inside cells is about ?

A	50 mmol/L
B	100 mmol/L
C	150 mmol/L
D	200 mmol/L

Question 1 Explanation:

Normal plasma K+ concentration is 3.5 - 5.0 mmol/L, whereas that inside cells is about 150 mmol/ L. <2% of total body K+ content (2500 - 4500 mmol) is in ECF.

Question 2

Normally, ratio of ICF to ECF K+ concentration is ?

A	28:1
B	38:1
C	48:1
D	58:1

Question 2 Explanation:

Normally, ratio of ICF to ECF K+ concentration is 38:1 due to resting membrane potential and is crucial for normal neuromuscular function

Question 3

The basolateral Na-K ATPase pump actively transports potassium in & sodium out of the cell in a ratio of ?

A	1 : 2
B	2 : 3
C	3 : 4
D	4 : 5

Question 3 Explanation:

The basolateral Na+, K+-ATPase pump actively transports K+ in and Na+ out of the cell in a 2:3 ratio, and the passive outward diffusion of K+ is quantitatively the most important factor that generates the resting membrane potential

Question 4

K+ intake in an average western diet is ?

A	10 - 40 mmol/day
B	40 - 120 mmol/day
C	120 - 350 mmol/day
D	350 - 550 mmol/day

Question 4 Explanation:

K+ intake in an average western diet is 40 - 120 mmol/day, or approximately 1 mmol/kg per day, 90% of which is absorbed by the gastrointestinal tract

Question 5

Potassium delivery to distal nephron approximates ?

A	Dietary excess
B	Dietary intake
C	Dietary deficiency
D	Dietary deficiency

Question 5 Explanation:

K+ delivery to the distal nephron [DCT + cortical collecting duct (CCD)] approximates dietary intake

Question 6

All regulation of renal potassium excretion & total body potassium balance occurs in ?

A	Proximal convoluted tubule
B	Loop of Henle
C	Distal nephron
D	All of the above

Question 6 Explanation:

Virtually all regulation of renal K+ excretion & total body K+ balance occurs in distal nephron

Question 7

Aldosterone is secreted by zona glomerulosa cells of adrenal cortex in response to ?

A	High renin
B	High angiotensin II
C	Hyperkalemia
D	All of the above

Question 7 Explanation:

Aldosterone is secreted by the zona glomerulosa cells of the adrenal cortex in response to high renin and angiotensin II or hyperkalemia.

Question 8

Hypokalemia is defined as a plasma potassium concentration of ?

A	< 3.5 mmol/L
B	< 3.6 mmol/L
C	< 3.7 mmol/L
D	< 3.8 mmol/L

Question 8 Explanation:

Hypokalemia is defined as a plasma K+ concentration <3.6 mmol/L

Question 9

Which of the following is a cause of decreased potassium intake ?

A	Ingestion of excess carbohydrates
B	Ingestion of excess proteins
C	Ingestion of excess fats
D	Ingestion of clay (geophagia)

Question 9 Explanation:

Ingestion of clay (geophagia) is a cause of decreased K+ intake as it binds dietary K+ & iron

Question 10

Hypokalemia is associated frequently with ?

A	Metabolic acidosis
B	Metabolic alkalosis
C	Respiratory acidosis
D	Respiratory alkalosis

Question 10 Explanation:

Metabolic alkalosis is associated with hypokalemia due to K+ redistribution as well as excessive renal K+ loss.

Question 11

Which of the following is a cause of hypokalemia ?

A	Metabolic alkalosis
B	Treatment of DKA with insulin
C	Uncontrolled hyperglycemia
D	All of the above

Question 12

Which of the following is a cause of hypokalemia ?

A	A Patients of pernicious anemia treated with vitamin B12
B	Patients of neutropenia treated with GM-CSF
C	Massive transfusion with thawed washed RBCs
D	All of the above

Question 12 Explanation:

Treatment of DKA with insulin causes hypokalemia due movement of K+ inside the cells with glucose like anabolic states. Uncontrolled hyperglycemia causes K+ depletion due to osmotic diuresis.

Question 13

Which of the following is the least likely cause of hypokalemia ?

A	Excessive sweating
B	Loss of gastric secretions
C	Laxative abuse
D	None of the above

Question 13 Explanation:

K+ concentration of gastric fluid is only 5 - 10 mmol/L and is a less likely cause of hypokalemia

Question 14

Hypokalemia due to loss of gastric contents is due to ?

A	Volume depletion
B	Metabolic alkalosis
C	A+B
D	Neither A, nor B

Question 14 Explanation:

Loss of gastric contents results in volume depletion & metabolic alkalosis, both promote kaliuresis.

Question 15

Primary hyperaldosteronism is due to dysregulated aldosterone secretion by ?

A	Adrenal adenoma
B	Adrenal carcinoma
C	Adrenocortical hyperplasia
D	All of the above

Question 15 Explanation:

Primary hyperaldosteronism is due to dysregulated aldosterone secretion by an adrenal adenoma (Conn’s syndrome) or carcinoma or to adrenocortical hyperplasia.

Question 16

Tumor that produce renin include ?

A	Renal cell carcinoma
B	Ovarian carcinoma
C	Wilms' tumor
D	All of the above

Question 16 Explanation:

Renin-secreting tumors of juxtaglomerular apparatus, renal cell carcinoma, ovarian carcinoma, and Wilms’ tumor produce renin.

Question 17

‘Syndrome of apparent mineralocorticoid excess' is due to deficiency of ?

A	11a-HSDH
B	11P-HSDH
C	12a-HSDH
D	12P-HSDH

Question 17 Explanation:

Cortisol is converted to cortisone by 11 fi-hydroxysteroid dehydrogenase (11fi-HSDH). 11fi-HSDH deficiency or suppression allows cortisol to bind to the aldosterone receptor & leads to syndrome of apparent mineralocorticoid excess

Question 18

Conditions that inhibit the activity of ‘11P-HSDH' include ?

A	Glycyrrhetinic acid in licorice
B	Chewing tobacco
C	Carbenoxolone
D	All of the above

Question 18 Explanation:

Glycyrrhetinic acid (in licorice), chewing tobacco & carbenoxolone inhibit activity of 11fi-HSDH.

Question 19

Which of the following is false about ‘Liddle’s syndrome’ ?

A	Autosomal dominant
B	Hypertension
C	Hypokalemic metabolic alkalosis
D	Excess renin and aldosterone secretion

Question 19 Explanation:

Liddle’s syndrome is an autosomal dominant disease characterized by hypertension, hypokalemic metabolic alkalosis, renal K+ wasting & suppressed renin & aldosterone secretion

Question 20

Bartter’s syndrome is characterized by ?

A	Hypokalemia
B	Metabolic alkalosis
C	Hyperreninemic hyperaldosteronism
D	All of the above

Question 20 Explanation:

Bartter’s syndrome is characterized by hypokalemia, metabolic alkalosis, hyperreninemic hyperaldosteronism secondary to ECF volume contraction & juxtaglomerular apparatus hyperplasia

Question 21

Which of the following laboratory abnormalities is seen only in chronic renal failure ?

A	Anemia
B	Hypocalcemia
C	Hyperphosphatemia
D	Radiographic evidence of renal osteodystrophy

Question 22

Which of the following is false regarding ECG changes of hypokalemia ?

A	Delayed ventricular repolarization
B	Do not correlate well with plasma K+ levels
C	Prominent U wave
D	Shortened QU interval

Question 22 Explanation:

ECG changes of hypokalemia are due to delayed ventricular repolarization and do not correlate well with the plasma K+ concentration. Early changes include flattening or inversion of T wave, prominent U wave, ST-segment depression, and prolonged QU interval.

Question 23

Which of the following ECG changes denote severe K+ depletion ?

A	Prominent U wave
B	Inversion of T wave
C	Prolonged PR interval
D	Prolonged QU interval

Question 23 Explanation:

Severe K+ depletion may result in a prolonged PR interval, decreased voltage and widening of the QRS complex and ventricular arrhythmias.

Question 24

Hypokalemia with minimal renal potassium excretion suggests that potassium loss is through ?

A	Skin
B	Gastrointestinal tract
C	Diuretic use
D	Any of the above

Question 24 Explanation:

Hypokalemia with minimal renal K+ excretion (<15 mmol/day of K+ in urine) suggests that K+ was lost via the skin or gastrointestinal tract or that there is a remote history of vomiting or diuretic use

Once you are finished, click the button below. Any items you have not completed will be marked incorrect. Get Results

There are 24 questions to complete.

←

List

→

Return

Shaded items are complete.

1	2	3	4	5
6	7	8	9	10
11	12	13	14	15
16	17	18	19	20
21	22	23	24	End

Return

See all quizzes of Hypernatremia at here:

1.Hypernatremia is defined as a plasma sodium concentration more than ?
A. 135 mmol/L
B. 140 mmol/L
C. 145 mmol/L
D. 150 mmol/L

2.Which of the following about hypernatremia is false ?
A. State of iso-osmolality
B. Results in ICF volume contraction
C. Stimulates thirst
D. Excretion of minimum volume of maximally concentrated urine

3. Which of the following is not a secretory diarrhea ?
A. Cholera
B. Carcinoid
C. Lactulose induced
D. VIPoma
4. Which of the following about diabetes insipidus is false ?
A. CDI is characterized by impaired AVP secretion
B. NDI results from renal resistance to actions of AVP
C. Familial CDI is inherited as autosomal recessive
D. Familial CDI is due to mutation in propressophysin gene

5. Which of the following about nephrogenic diabetes insipidus is false ?
A. Congenital Nephrogenic diabetes insipidus (NDI) is X-linked
recessive trait due to mutations in V2 receptor gene
B. Congenital Nephrogenic diabetes insipidus (NDI) may be
due to mutation in autosomal aquaporin-2 gene
C. Lithium, hypercalcemia & hyperkalemia cause sporadic NDI
D. Pregnant women, in II or III trimester, may develop NDI due
to excessive vasopressinase from placenta

6. Major symptoms of hypernatremia are ?
A. Cardiac
B. Neurologic
C. Respiratory
D. All of the above

7. ‘Solute excretion rate’ is ?
A. Urine volume x Osmolality
B. Urine volume x Urine sodium
C. Urine volume x Urine potassium
D. Urine volume x Urine bicarbonate

8. After administering ‘desmopressin’, urine osmolality should increase by how much in CDI ?

A. At least 10 %
B. At least 25 %
C. At least 35 %
D. At least 50 %
9. After administering ‘desmopressin’, urine osmolality should increase by how much in NDI ?
A. At least 10%
B. At least 25%
C. At least 35%
D. None of the above

10. In hypernatremia due to water loss, water deficit should be corrected in which of the following ways ?
A. Rapidly
B. Over 12 to 24 hours
C. Over 24 to 36 hours
D. Slowly over at least 48 to 72 hours

11. Drugs that either stimulate AVP secretion or enhance its action on the kidney includes all except ?
A. Chlorpropamide
B. Clofibrate
C. Carbamazepine
D. Phenytoin

12. Which of the following drugs is useful in NDI patients who have to take lithium ?
A. Amiloride
B. Chlorpropamide
C. Clofibrate
D. Carbamazepine

13. Hypokalemia with Transtubular K+ concentration gradient (TTKG) greater than how much suggests renal K+ loss due to increased distal K+ secretion ?
A. 1
B. 2

C. 3
D. 4

14. A decrement of 1 mmol/L in plasma potassium concentration may represent a total body potassium deficit of ?
A. 20 to 40 mmol
B. 50 to 100 mmol
C. 100 to 200 mmol
D. 200 to 400 mmol

15. Plasma potassium levels of < 3 mmol/L require how much potassium to correct the deficit ?
A. 100 mmol
B. 200 mmol
C. 400 mmol
D. 600 mmol

16. It is generally safer to correct hypokalemia via which route ?
A. Oral
B. Peripheral vein
C. Central vein
D. Per rectum

17. Which is the preparation of choice for correction of hypokalemia with metabolic alkalosis?
A. Potassium chloride
B. Potassium bicarbonate
C. Potassium citrate
D. None of the above

18. Rate of IV infusion of potassium in severe hypokalemia should not exceed ?
A. 20 mmol/hour
B. 40 mmol/hour
C. 60 mmol/hour
D. 80 mmol/hour

19. Through a peripheral vein, maximum concentration of administered K+ should be no more than ?
A. 20 mmol/L

B. 40 mmol/L
C. 60 mmol/L
D. 80 mmol/L

20. Ideally, for infusion KCl should be mixed in ?
A. Normal saline
B. Dextrose solutions
C. Ringer solutions
D. Any of the above

Hypernatremia

I. Start the exam by click the “Start” button

Hypokalemia

Share this:

Related

[MCQ] Hypokalemia

[MCQ] Hyperkalemia

You may also like

Leave a Comment Cancel Reply