anatomy 2- ch 27

An elderly man is on a salt-restricted diet due to heart disease. He has emphysema, kidney damage and stress incontinence. Which of the following disorders is he likely to have or develop? A. acidosis B. dehydration C. hyponatremia D. A and B are correct. E. A, B and C are correct.

d

At the midpoint of the normal arterial blood pH range, the ratio of HCO3- to H2CO3 is A. 24:22 B. 1:20 C. 22:24 D. 20:1 E. 24:1

d

Bicarbonate ions (HCO3-) A. are generated by the intercalated cells of the kidneys. B. are generated by the parietal cells of the stomach. D. A and B are correct.

d

Each of the following stimulates increased ADH release EXCEPT: A. diarrhea B. a large burn C. vomiting D. hypothermia E. excessive perspiration

d

H?+ secreted into the tubular fluid of the collecting duct are buffered by A. HPO42- B. NH3 C. HCO3- D. A and B are correct. E. A, B and C are correct.

d

How proteins function as buffers? A. by releasing H+ from their terminal carboxyl groups when pH rises B. by absorbing H+ on to their terminal amino groups when pH falls C. by converting H+ to H2. D. A and B are correct. E. A, B and C are correct.

d

Phosphate ions A. are important parts of key biological molecules such as DNA, RNA and ATP. B. occur mostly as HPO42- at physiological pH. C. are regulated primarily by PTH. D. All of these are correct. E. are important buffers.

d

Which mechanism allows the kidneys to excrete urine that is a thousand times more acidic than plasma? A. apical Cl-/HCO3- antiporters in the intercalated cells of the DCT B. basolateral proton pumps in the intercalated cells of the DCT C. basolateral Cl-/HCO3- antiporters in the intercalated cells of the DCT D. apical proton pumps in the intercalated cells of the distal convoluted tubule (DCT) E. Na+/H+ antiporters in the proximal convoluted tubule

d

Each of the following electrolytes is found in higher concentrations in intracellular fluid than in extracellular fluid EXCEPT: A. K+ B. Cl- C. HPO4- D. Mg2+ E. SO42-

B

Which barriers separate body fluids into different compartments? A. plasma membranes B. blood vessel walls C. nuclear membranes D. A and B are correct. E. A, B and C are correct.

D

A two year old child ate 100 of his grandparents' antacid tablets thinking that they were candy. The bottle says the antacids contain calcium carbonate. Which of the following signs and symptoms might the child exhibit when examined in the emergency department of the local hospital? A. lethargy B. numbness and tingling in his fingers C. hyperactive reflexes D. muscle cramps E. tetany

a

Each of the following conditions is associated with respiratory acidosis EXCEPT: A. hyperventilation B. asthma C. pulmonary edema D. emphysema E. damage to the diaphragm or other breathing muscles

a

Most of the extracellular fluid is located A. between the cells. B. within the lymphatic vessels. C. within the blood vessels. D. within the brain and spinal cord ventricles. E. within joint cavities.

a

Physiological buffers A. All of these are correct. B. include phosphate and carbonic acid-bicarbonate systems. C. include proteins such as albumin and hemoglobin. D. usually consist of a weak acid and its salt. E. prevent drastic pH changes in body fluids.

a

The most important role of the phosphate system is to buffer the A. cytosol. B. plasma. C. interstitial fluid. D. urine. E. B and C are correct

a

When ANP levels rise, A. Aldosterone levels decrease. B. ADH levels increase. C. Blood volume and blood pressure increase. D. More Na+ is reabsorbed in the kidney tubules. E. Renin secretion increases.

a

When dihydrogen phosphate ion acts as a weak acid and buffers OH?-, the products are A. H2O and HPO42-. B. H2O and H2PO4-. C. H2PO4- and PO43-. D. H2PO4- and HPO42-. E. HPO42- and PO43

a

When does hemoglobin act as a buffer? A. when it releases O2 and picks up H+ B. when it releases CO2 and picks up H+ C. when it picks up O2 and releases CO2 D. when it converts O2 to CO2 E. when it converts CO2 to HCO3

a

Which control mechanism increases body fluid pH but does not remove acid from the body? A. buffer system B. exhalation of CO2 C. kidney excretion of H+ D. A and B are correct. E. A, B and C are correct.

a

Which of the following changes that impact fluid, electrolyte and acid-base balance is associated with increased age EXCEPT: A. increased intracellular fluid volume B. decreased respiratory function C. increased mass of adipose tissue D. decreased kidney function E. decreased total body K+ level

a

Calcium ions (Ca2+) A. are found primarily in intracellular fluid. B. are important in blood clotting and neurotransmitter release. C. are regulated primarily by aldosterone, ANP and ADH. D. are important in regulating osmolarity. E. are unnecessary for muscle contraction

b

Chloride ions (Cl-) A. are the least abundant anions in extracellular fluid. B. tend to follow the movements of Na+ . C. are regulated directly by calcitonin. D. move with difficulty between fluid compartments. E. help balance levels of cations in different fluid compartments

b

Each of the following is classified as an extracellular fluid EXCEPT: A. lymph B. cytosol C. plasma D. synovial fluid E. cerebrospinal fluid

b

In the carbonic acid-bicarbonate buffer system, A. CO2 is removed by the lungs. B. All of these are correct. C. HCO3- acts as a weak base. D. HCO3- can bind excess H+ present, producing H2CO3. E. H2CO3 is converted to water and CO2.

b

Respiratory alkalosis A. is usually caused by respiratory arrest. B. occurs when the arterial PCO2 falls below 35 mmHg. C. may be associated with diarrhea and vomiting. D. will result in the kidneys excreting more H+ and reabsorbing more HCO3-. E. results in an arterial pH less than 7.35 if there is no compensation.

b

Which individual is NOT at risk of a fluid or electrolyte imbalance? A. a hospitalized person receiving intravenous fluids B. a healthy adult living independently C. someone dependent on others for food and drink D. a patient with congestive heart failure being treated with diuretics E. a patient with 2nd degree burns over 45% of her body

b

Which of the following is considered within normal limits (WNL) for arterial blood? A. HCO3-: H2CO3 20:1 B. All of these are correct. C. HCO3- 22-26 mEq/L D. pH 7.35-7.45 E. PCO2 35-35 mmHg

b

Which of the following is correct? A. The primary factor determining body fluid loss is urinary water loss. B. Hormones regulating the extent of Na+ reabsorption are angiotensin II, aldosterone and ANP. C. The elimination of excess body water occurs mainly by perspiration. D. The primary factor determining body fluid osmolarity is urinary salt loss. E. All of these are correct.

b

Which person listed would have the largest percentage of water in his or her body? A. a lean adult female who is not an athlete B. an infant C. a ten year old child D. an adult male competitive swimmer E. an obese adult female

b

A patient is anorexic and abuses laxatives. She is most likely to develop A. respiratory acidosis. B. respiratory alkalosis. C. metabolic acidosis. D. metabolic alkalosis. E. Either B or D is correct.

c

ADH A. secretion is unaffected by changes in plasma osmolarity. B. secretion is stimulated by ANP. C. is the main hormone that regulates water loss. D. secretion is unaffected by changes in blood volume. E. is synthesized by the posterior pituitary gland and released from the hypothalamus.

c

Acidosis A. allows conduction of impulses in peripheral nerves in the absence of normal stimuli. B. is associated with excessive irritability of central nervous system. C. refers to an arterial blood pH less than 7.35. D. All of these are correct. E. results in nervousness, muscle spasms, convulsions and death.

c

If water loss exceeds water intake, A. the thirst center in the medulla oblongata will stimulate the desire to drink water. B. angiotensin II levels will decrease. C. dehydration will occur. D. ADH levels will decrease. E. blood pressure will rise

c

Magnesium ions (Mg2+) A. are cofactors for lipid metabolism. B. are important extracellular anions. C. are required for release of PTH. D. are regulated by ANP and aldosterone. E. are excreted in feces but not in urine

c

Taking a dare, a student drank 4 L (over a gallon) of water in less than 10 minutes. How will the student's body compensate for this increased fluid volume? A. Angiotensin II and aldosterone levels will fall. B. Renin secretion will be inhibited. C. All of these are correct. D. ADH levels will fall. E. The kidneys will produce large amounts of dilute urine quickly

c

The normal pH range for arterial blood is A. 7.25-7.35 B. 7.05-7.15 C. 7.35-7.45 D. 7.45-7.55 E. 7.15-7.25

c

Which of the following is NOT characterized by vomiting? A. hypercalcemia B. hyperkalemia C. hypernatremia D. hypermagnesemia E. hyperphosphatemia

c

Which of the following lists body sites in order of increasing water loss? A. GI tract, skin, lungs, kidneys B. kidneys, skin, lungs, GI tract C. GI tract, lungs, skin, kidneys D. kidneys, lungs, skin, GI tract E. lungs, GI track, skin, kidneys

c

Which statement about electrolytes is NOT correct? A. They control the movement of water between fluid compartments. B. They serve as cofactors for some enzymes. C. They are less numerous than nonelectrolytes and move freely between fluid compartments. . D. They help maintain acid-base balance. E. They carry electrical current

c

Which ions are directly affected by PTH and calcitriol levels? A. Ca2+ B. HPO42- C. Na+ D. A and B are correct. E. A, B and C are correct

d.

Body fluids A. consist of water and dissolved solutes. B. constitute over 50% of the mass of a lean adult. C. are described as intracellular or extracellular based on their locations. D. A and B are correct E. A, B and C are correct.

e

Each of the following is characterized by mental confusion EXCEPT: A. hypophosphatemia B. hypokalemia C. hypomagnesemia D. hyponatremia E. hypochloremia

e

How do infants differ from adults in fluid distribution, regulation of fluid and electrolyte balance, and acid-base homeostasis? A. Infants lose less water through their lungs. B. The metabolic rates of adults are higher than those of infants. C. Water loss through the skin is significantly higher in adults than in infants. D. The rate of fluid intake and output is about seven times higher in adults than in infants. E. Typically, 75% or more of an infant's body mass is water.

e

Plasma contains A. more Na+ than interstitial fluid but less Na+ than intracellular fluid. B. less HCO3- than either interstitial fluid or intracellular fluid. C. more K+ than interstitial fluid but less K+ than intracellular fluid. D. more Cl- than interstitial fluid but less Cl- than intracellular fluid. E. more protein anions than interstitial fluid but fewer protein anions than intracellular fluid.

e

Potassium ions (K+) A. are critical to the repolarization phase of an action potential. B. help maintain fluid and pH balance. C. are essential to establishing the resting membrane potential. D. are the most abundant cations in intracellular fluid. E. All of these are correct.

e

Sodium ions (Na+) A. are required for the repolarization phase of action potentials. B. move between fluid compartments in response to PTH. C. are the most abundant anions in extracellular fluid. D. All of these are correct. E. contribute about one-half of the osmolarity of extracellular fluid.

e

Sources of water gain include A. ingestion B. dehydration synthesis reactions C. aerobic cellular respiration D. A and B are correct. E. A, B and C are correct

e

The pH of body fluids is a measurement of the ____ concentration of those fluids. A. Cl- B. Na+ C. Ca2+ D. K+ E. H+

e

Which electrolytes are important in action potentials and the excitability of nervous and muscle tissue? A. Na+ B. K+ C. Ca2+ D. A and B are correct. E. A, B and C are correct

e

Which of the following is correct? A. Most CO2 in body fluids is in the form of H2CO3. B. Reducing the ventilation rate raises pH. C. Doubling the ventilation rate lowers pH. D. Changes in ventilation rate can change body fluid pH, but the change will take hours. E. Increasing the concentration of CO2 in body fluids lowers their pH.

e