[MCQ] Hyponatremia- Part 2

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Hyponatremia- Part 2

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Question 1

V(2) receptors located in ?

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

Question 2

V(1B) receptors located in ?

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

Question 2 Explanation:

Activation of V(1A) receptors located in vascular smooth muscle cells & myocardium results in vasoconstriction & increased afterload & hypertrophy. V(2) receptors located in principal cells of renal-collecting-duct system & mediate free water absorption. V(1B) receptors are located in anterior pituitary & mediate adrenocorticotropin hormone release. Cardiovascular & renal effects of AVP are mediated primarily by V(1A) and V(2) receptors.

Question 3

Which of the following is a combined V(1A) / V(2)-receptor antagonist ?

A	Mozavaptan
B	Tolvaptan
C	Conivaptan
D	Lixivaptan

Question 3 Explanation:

Conivaptan is a combined V(1A) / V(2)-receptor antagonist (non-selective) that induces diuresis as well as haemodynamic improvement

Question 4

Which of the following is a selective V(1A) receptor antagonist ?

A	Mozavaptan
B	Tolvaptan
C	Relcovaptan
D	Lixivaptan

Question 4 Explanation:

Relcovaptan is a selective V1a-receptor antagonist used in the treatment of Raynaud's disease, dysmenorrhoea, and tocolysis.

Question 5

Which of the following is a V2-receptor antagonist ?

A	Mozavaptan
B	Satavaptan
C	Tolvaptan
D	All of the above

Question 5 Explanation:

V2-receptor antagonists - mozavaptan, lixivaptan, satavaptan & tolvaptan, induce a highly hypotonic diuresis without substantially affecting excretion of electrolytes (by contrast with effects of diuretics). These are effective in the treatment of euvolaemic & hypervolaemic hyponatraemia

Question 6

Which of the following is administered intravenously ?

A	Mozavaptan
B	Tolvaptan
C	Conivaptan
D	Lixivaptan

Question 6 Explanation:

Conivaptan is available for intravenous (IV) administration, whereas the other three agents are for oral administration

Question 7

Which of the following is a Benzodiazepine derivative ?

A	Mozavaptan
B	Tolvaptan
C	Conivaptan
D	Lixivaptan

Question 7 Explanation:

Tolvaptan, Mozavaptan & Conivaptan are benzazepine derivative, Satavaptan is N-arylsulfonyl oxindole derivative, Lixivaptan is a Benzodiazepine derivative.

Question 8

Vaptans are metabolised by which of the following hepatic cytochrome enzymes ?

A	CYP2D6
B	CYP2C9
C	CYP3A4
D	CYP2C19

Question 9

V2-receptor antagonists are contraindicated in which of the following conditions ?

A	Hypovolaemic hyponatraemia
B	Euvolaemic hyponatraemia
C	Hypervolaemic hyponatraemia
D	None of the above

Question 9 Explanation:

Conivaptan & other V2-receptor antagonists are contraindicated in patients with hypovolaemic hyponatraemia, since it is an aquaretic

Question 10

Blood tonicity associated with hyponatremia is ?

A	Low
B	Normal
C	High
D	Any of the above

Question 10 Explanation:

Hyponatremia can be associated with low, normal, or high blood tonicity.

Question 11

Which of the following about pseudohyponatremia is false ?

A	Iso-osmolar & isotonic hyponatremia
B	Iso-osmolar & isotonic hyponatremia
C	Increase in solid phase of plasma
D	None of the above

Question 11 Explanation:

Pseudohyponatremia is a spurious form of iso-osmolar & isotonic hyponatremia when severe hypertriglyceridemia or paraproteinemia increases substantially the solid phase of plasma.

Question 12

Sodium required to correct hyponatremia can be estimated by multiplying the deficit in plasma sodium concentration by ?

A	Weight
B	Height
C	Total body water
D	Urine output in liters

Question 12 Explanation:

Quantity of Na+ required to increase plasma Na+ concentration by a given amount can be estimated by multiplying the deficit in plasma Na+ concentration by total body water

Question 13

Quantity of sodium in 0.9% (normal, isotonic) saline is ?

A	77 mEq/L
B	154 mEq/L
C	256 mEq/L
D	513 mEq/L

Question 14

In hyponatremia, plasma Na+ concentration during the first 24 hours should not be more than ?

A	6 mmol/L
B	8 mmol/L
C	10 mmol/L
D	12 mmol/

Question 14 Explanation:

In hyponatremia, plasma Na+ concentration during the first 24 hours should not be more than 12 mmol/L and less than 6 mmol/L/day thereafter.

Question 15

In a 70 kg man, to raise plasma Na+ concentration from 110 to 120 mmol/L, what is the amount of Na+ required ?

A	420 mmol
B	440 mmol
C	460 mmol
D	480 mmol

Question 15 Explanation:

To raise plasma Na+ concentration from 110 to 120 mmol/L in a 70-kg man requires 420 mmol [(120 – 110)x70x0.6] of Na+. Total body water is 50 & 60% of lean body weight in women or men respectively.

Question 16

Osmotic demyelination syndrome (ODS) includes?

A	Flaccid paralysis
B	Dysarthria
C	Dysphagia
D	All of the above

Question 16 Explanation:

If hyponatremia is corrected too rapidly, osmotic demyelination syndrome (ODS) develops which is characterized by flaccid paralysis, dysarthria and dysphagia (central pontine myelinolysis). Patients with chronic hyponatremia are most susceptible to develop

Question 17

Risk factors for ODS include ?

A	Rapid or overcorrection of hyponatremia
B	Prior cerebral anoxic injury
C	Hypokalemia
D	All of the above

Question 18

Which of the following is related to central pontine myelinolysis ?

A	Cerebral oedema
B	Cerebral dehydration
C	Cerebral atrophy
D	None of the above

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See all quizzes of Hyponatremia at here:

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

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

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

4. V(1A) receptors located in ?
A. Vascular smooth muscle cells & myocardium
B. Collecting tubules
C. Anterior pituitary
D. All of the above
5. V(2) receptors located in ?
A. Vascular smooth muscle cells & myocardium
B. Collecting tubules
C. Anterior pituitary
D. All of the above
6. V(1B) receptors located in ?
A. Vascular smooth muscle cells & myocardium
B. Collecting tubules
C. Anterior pituitary
D. All of the above

7. Which of the following is a combined V(1A) / V(2)-receptor antagonist ?
A. Mozavaptan
B. Tolvaptan
C. Conivaptan
D. Lixivaptan
8. Which of the following is a selective V(1A) receptor antagonist ?
A. Mozavaptan
B. Tolvaptan
C. Relcovaptan
D. Lixivaptan

9. Which of the following is a V2-receptor antagonist ?
A. Mozavaptan
B. Satavaptan
C. Tolvaptan
D. All of the above

10. Which of the following is administered intravenously ?
A. Mozavaptan
B. Tolvaptan
C. Conivaptan
D. Lixivaptan

11. Which of the following is a Benzodiazepine derivative ?
A. Mozavaptan
B. Tolvaptan
C. Conivaptan
D. Lixivaptan

12. Vaptans are metabolised by which of the following hepatic cytochrome enzymes ?
A. CYP2D6
B. CYP2C9
C. CYP3A4
D. CYP2C19

13. Vaptans are excreted through ?
A. Urine
B. Faeces
C. Lungs
D. All of the above
14. V2-receptor antagonists are contraindicated in which of the following conditions ?
A. Hypovolaemic hyponatraemia
B. Euvolaemic hyponatraemia
C. Hypervolaemic hyponatraemia
D. None of the above

15. Blood tonicity associated with hyponatremia is ?
A. Low
B. Normal
C. High
D. Any of the above

16. Which of the following about pseudohyponatremia is false ?
A. Iso-osmolar & isotonic hyponatremia
B. Severe hypertriglyceridemia or paraproteinemia
C. Increase in solid phase of plasma
D. None of the above

17. Sodium required to correct hyponatremia can be estimated by multiplying the deficit in plasma sodium concentration by ?
A. Weight
B. Height
C. Total body water
D. Urine output in liters

18. Quantity of sodium in 0.9% (normal, isotonic) saline is ?
A. 77 mEq/L
B. 154 mEq/L
C. 256 mEq/L
D. 513 mEq/L
19. In hyponatremia, plasma Na+ concentration during the first 24 hours should not be more than ?
A. 6 mmol/L
B. 8 mmol/L

C. 10 mmol/L
D. 12 mmol/L

20. In a 70 kg man, to raise plasma Na+ concentration from 110 to 120 mmol/L, what is the amount of Na+ required ?
A. 420 mmol
B. 440 mmol
C. 460 mmol
D. 480 mmol

21. Osmotic demyelination syndrome (ODS) includes ?
A. Flaccid paralysis
B. Dysarthria
C. Dysphagia
D. All of the above

22. Risk factors for ODS include ?
A. Rapid or overcorrection of hyponatremia
B. Prior cerebral anoxic injury
C. Hypokalemia
D. All of the above

23. Which of the following is related to central pontine myelinolysis ?
A. Cerebral oedema
B. Cerebral dehydration
C. Cerebral atrophy
D. None of

Hyponatremia

[MCQ] Hyponatremia- Part 2

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Hyponatremia- Part 2

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