[MCQ] Hyponatremia- Part 1

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Hyponatremia- Part 1

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Question 1

Plasma sodium concentration falls by how much for every 100 mg/dL rise in plasma glucose concentration ?

A	1.2 mmol / L
B	1.4 mmol / L
C	1.6 mmol / L
D	1.8 mmol / L

Question 1 Explanation:

Plasma Na+ falls by 1.4 mmol/L for every 100 mg/dL rise in plasma glucose concentration

Question 2

Urine tonicity is calculated by ?

A	[Na+] + [K+] - [Cl-]
B	[Na+] x [K+]
C	[Na+] x [K+] ÷ [Cl-]
D	[Na+] x [K+] ÷ [Cl-]

Question 2 Explanation:

Urine tonicity is calculated as the sum of concentrations of Na+ and K+

Question 3

‘Diuretic-induced hyponatremia’ is almost always due to ?

A	Thiazide diuretics
B	Thiazide diuretics
C	Aldosterone antagonists
D	All of the above

Question 3 Explanation:

Diuretic-induced hyponatremia is almost always due to thiazide diuretics which lead to Na+ & K+ depletion & AVP-mediated water retention. Loop diuretics decrease tonicity of medullary interstitium & impair maximal urinary concentrating capacity which limits ability of AVP to promote water retention.

Question 4

‘Syndrome of inappropriate antidiuretic hormone secretion’ (SIADH) causes ?

A	Normovolemic hyponatremia
B	Hypovolemic hyponatremia
C	Hypervolemic hyponatremia
D	Any of the above

Question 4 Explanation:

Syndrome of inappropriate antidiuretic hormone secretion (SIADH) is the most common cause of normovolemic or euvolemic hyponatremia.

Question 5

Which of the following conditions can cause hyponatremia ?

A	Hypothyroidism
B	Hyperthyroidism
C	Hyperthyroidism
D	Pheochromocytoma

Question 5 Explanation:

Adrenal insufficiency & hypothyroidism may cause hyponatremia. Hypothyroidism decreases cardiac output and GFR and thus increased AVP secretion leading to hyponatremia

Question 6

Renal excretory capacity is ?

A	12 liter / day
B	15 liter / day
C	18 liter / day
D	20 liter / day

Question 6 Explanation:

Normally, renal excretory capacity is large of 12 liters per day.

Question 7

‘Osmotic diuresis’ is defined as a solute excretion rate of more than ?

A	~ 250 mosmol/day
B	~ 450 mosmol/day
C	~ 550 mosmol/day
D	~ 750 mosmol/day

Question 7 Explanation:

Osmotic diuresis refers to a solute excretion rate of > ~750 mosmol/day

Question 8

Phenomenon of ‘hyponatremia’ in beer drinkers is called ?

A	Beer syndrome
B	Beer flush
C	Beer potomania
D	Beer psychosis

Question 8 Explanation:

Beer drinkers have poor dietary intake of protein & electrolytes & consume large volumes of beer, which may exceed renal excretory capacity and result in hyponatremia. This is referred to as beer potomania

Question 9

Stupor, seizures, and coma occur when plasma sodium concentration falls acutely below ?

A	123 mmol/L
B	122 mmol/L
C	121 mmol/L
D	120 mmol/L

Question 9 Explanation:

Stupor, seizures & coma occur when plasma Na+ concentration falls acutely below 120 mmol/L

Question 10

The finding of urine sodium concentration >20 mmol/L in hypovolemic hyponatremia implies ?

A	Salt-wasting nephropathy
B	Salt-wasting nephropathy
C	Hypoaldosteronism
D	All of the above

Question 10 Explanation:

Urine Na+ concentration >20 mmol/L in hypovolemic hyponatremia implies a salt-wasting nephropathy, diuretic therapy, hypoaldosteronism or vomiting.

Question 11

Which of the following statements about SIADH is false ?

A	Hypoosmotic hyponatremia
B	Urine osmolality >100 mosmol/kg
C	Hypervolemia
D	Normal sodium balance

Question 11 Explanation:

Patients with SIADH are usually euvolemic.

Question 12

Which of the following statements about SIADH is false ?

A	Normal renal, adrenal, and thyroid function
B	Normal potassium and acid-base balance
C	Hypouricemia
D	None of the above

Question 12 Explanation:

(urine osmolality >100 mosmol/kg). Patients are typically normovolemic & have normal Na+ balance. They tend to be mildly volume-expanded secondary to water retention & have a urine Na+ excretion rate equal to intake (urine Na+ concentration usually >40 mmol/L). By definition, they have normal renal, adrenal & thyroid function & usually have normal K+ & acid-base balance. Hypouricemia in SIADH is due to uricosuric state induced by volume expansion. In contrast, hypovolemic patients tend to be hyperuricemic secondary to increased proximal urate reabsorption.

Question 13

What percentage of increase in brain volume can be fatal ?

A	2% to 4%
B	4% to 6%
C	6% to 8%
D	8% to 10%

Question 13 Explanation:

If plasma is dilute, water diffuses into brain by osmosis causing dilution of extracellular fluid in brain & swelling of brain cells. An increase in brain volume of 8% to 10% can be fatal. By cerebral osmoregulatory (adaptive) mechanism brain cells pump out myoinositol, glutamine, glycerophosphorylcholine, betaine, creatine & taurine to restore osmolality of cerebral ECF & limiting swelling of brain cells. Acute hyponatremia may cause cerebral edema due to underlying osmotic interactions between brain cells and the extracellular fluid compartment

Question 14

Physiologic functions of AVP include ?

A	Contraction of vascular smooth muscle
B	Stimulation of liver glycogenolysis
C	Regulation of corticotropin release
D	Regulation of corticotropin release

Question 14 Explanation:

Physiologic functions of AVP or antidiuretic hormone include contraction of vascular smooth muscle, stimulation of liver glycogenolysis, regulation of corticotropin release and renal antidiuresis

Question 15

Inappropriately elevated levels of AVP are found in ?

A	Congestive heart failure
B	Cirrhosis of liver
C	SIADH
D	All of the above

Question 15 Explanation:

Inappropriately elevated levels of AVP occur in CHF, cirrhosis liver, treatment with diuretics & SIADH

Question 16

Which of the following is a arginine-vasopressin-receptor subtype ?

A	V1a
B	V1b
C	V2
D	All of the above

Question 16 Explanation:

Arginine vasopressin (AVP) is a neuropeptide hormone. Three arginine-vasopressin-receptor subtypes V1a, V1b, and V2 belong to the large rhodopsin-like G-protein-coupled receptor family. V1A & V1B receptors are linked to phosphoinositol signaling pathway, with intracellular calcium acting as the second messenger, whereas V2 receptors are linked to adenylate cyclase signaling pathway, with intracellular cyclic adenosine monophosphate (cAMP) acting as second messenger.

Question 17

Non-peptide vasopressin receptor antagonists are called ?

A	Captans
B	Vaptans
C	Naptans
D	Saptans

Question 17 Explanation:

Vaptans are orally & intravenously active non-peptide vasopressin receptor antagonists. AVP receptor antagonists induces free water diuresis without natriuresis or kaliuresis, an effect termed aquaresis.

Question 18

V(1A) receptors located in ?

A	Vascular smooth muscle cells & myocardium
B	Collecting tubules
C	Anterior pituitary
D	All of the above

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See all quizzes of Hyponatremia at here:

1.Plasma sodium concentration falls by how much for every 100 mg/dL rise in plasma glucose concentration ?
A. 1.2 mmol / L
B. 1.4 mmol / L
C. 1.6 mmol / L
D. 1.8 mmol / L

2. Urine tonicity is calculated by ?
A. [Na+] + [K+] – [Cl–]
B. [Na+] x [K+]
C. [Na+] x [K+] ÷ [Cl–]
D. [Na+] + [K+]

3. ‘Diuretic-induced hyponatremia’ is almost always due to ?
A. Thiazide diuretics
B. Loop diuretics

C. Aldosterone antagonists
D. All of the above

4. ‘Syndrome of inappropriate antidiuretic hormone secretion’ (SIADH) causes ?
A. Normovolemic hyponatremia
B. Hypovolemic hyponatremia
C. Hypervolemic hyponatremia
D. Any of the above

5. Which of the following conditions can cause hyponatremia ?
Harrison’s 18th Ed 345
A. Hypothyroidism
B. Hyperthyroidism
C. Cushing’s disease
D. Pheochromocytoma

6. Renal excretory capacity is ?
A. 12 liter / day
B. 15 liter / day
C. 18 liter / day
D. 20 liter / day

7. ‘Osmotic diuresis’ is defined as a solute excretion rate of more than ?
A. ~ 250 mosmol/day
B. ~ 450 mosmol/day
C. ~ 550 mosmol/day
D. ~ 750 mosmol/day

8. Phenomenon of ‘hyponatremia’ in beer drinkers is called ?
A. Beer syndrome
B. Beer flush
C. Beer potomania
D. Beer psychosis

9. Stupor, seizures, and coma occur when plasma sodium concentration falls acutely below ?
A. 123 mmol/L

B. 122 mmol/L
C. 121 mmol/L
D. 120 mmol/L

10. The finding of urine sodium concentration >20 mmol/L in hypovolemic hyponatremia implies ?
A. Salt-wasting nephropathy
B. Diuretic therapy
C. Hypoaldosteronism
D. All of the above

11.Which of the following statements about SIADH is false ?
A. Hypoosmotic hyponatremia
B. Urine osmolality >100 mosmol/kg
C. Hypervolemia
D. Normal sodium balance

12. Which of the following statements about SIADH is false ?
A. Normal renal, adrenal, and thyroid function
B. Normal potassium and acid-base balance
C. Hypouricemia
D. None of the above

13. What percentage of increase in brain volume can be fatal ?
A. 2% to 4%
B. 4% to 6%
C. 6% to 8%
D. 8% to 10%

14. Physiologic functions of AVP include ?
A. Contraction of vascular smooth muscle
B. Stimulation of liver glycogenolysis
C. Regulation of corticotropin release
D. All of the above

15. Inappropriately elevated levels of AVP are found in ?
A. Congestive heart failure
B. Cirrhosis of liver
C. SIADH
D. All of the above

16. Which of the following is a arginine-vasopressin-receptor subtype ?
A. V1a
B. V1b
C. V2
D. All of the above

17. Non-peptide vasopressin receptor antagonists are called ?
A. Captans
B. Vaptans
C. Naptans
D. Saptans

18. V(1A) receptors located in ?
A. Vascular smooth muscle cells & myocardium
B. Collecting tubules
C. Anterior pituitary
D. All of the above

Hyponatremia

[MCQ] Hyponatremia- Part 1

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Hyponatremia- Part 1

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