Metabolic Alkalosis

possibly caused by vomiting, use of diuretics, or use of antacids.

Which of the following is NOT a risk factor for dehydration?

A) inefficient kidneys

B) vomiting

C) a high rate of insensible water loss

D) increased muscle mass

D) Increased muscle mass

T/F: The most abundant cation in intracellular fluid is potassium.

TRUE

In order to buffer a strong acid into a weak acid, which has a less dramatic effect on pH, what chemical should be used as the buffer?

Weak base

A patient is discovered to have a strange craving for iron objects. To try to determine the cause, her physician decides to order tests to determine if this patient might have some type of ______.

Anemia

Which hormone raises blood calcium levels?

PTH (parathyroid hormone)

The body's water volume is closely tied to a powerful water "magnet." What magnet is referred to here?

ionic Sodium

The most important renal mechanism for regulating acid-base balance of the blood involves __________.

maintaing HCO3- balance

Problems with fluid, electrolyte, and acid-base balance are particularly common in infants because of their ________.

insufficient kidneys

What is the hallmark of hypotonic hydration?

hyponatremia

What is the driving force for water intake?

Thirst

What accounts for the route through which most fluid is lost in a day?

Urine

The fluid link between the external and internal environment is ________.

Plasma

Which of the following is the only logical explanation for why hypocalcemia increases neuromuscular excitability and causes muscle tetany?

A) Low plasma calcium ion concentration decreases the release of calcium ions from the sarcoplasmic reticulum.

B) Low plasma calcium ion concentration decreases the rate of exocytosis of synaptic vesicles.

C) Low plasma calcium ion concentration increases the permeability of neuron membranes to sodium ions, thereby causing depolarization that in turn increases the likelihood of action potentials being generated.

D) Low plasma calcium ion concentration increases the likelihood of acetic acid and choline being formed in the synaptic cleft when a neuron is stimulated to the threshold level.

C) Low plasma calcium ion concentration increases the permeability of neuron membranes to sodium ions, thereby causing depolarization that in turn increases the likelihood of action potentials being generated.

The regulation of potassium balance ________.

involves aldosterone-induced secretion of patassium

Which of the choices below is not an essential role of salts in the body?

A) membrane permeability

B) anabolism of lipids

C) neuromuscular activity

D) secretory activity

B) Anabolism of lipids

What is the most common cation found in the interstitial fluid?

Na+ (sodium)

Which of the following is an electrolyte?

A) glucose

B) potassium

C) phospholipid

D) cholesterol

B) potassium

Sodium ions are highest in ___.

Blood Plasma

Potassium ions are highest in ___.

Intracellular fluid

Phosphate ions are highest in ___.

Intracellular fluid

bicarbonate ions are highest in ___.

Interstitial fluid

Proteins are highest in ___.

Intracellular fluid

Electrolytes

Dissociate in water

Nonelectrolytes

Do NOT dissociate in water

Extracellular

The fluid compartments outside the cell

Intracellular

Fluid compartments located within the cell

Interstitial

Spaced between cells

Newborn infants have a relatively higher ________ content in their ECF than do adults.

Sodium

Which of the following would NOT be expected to lead to edema?

A) incompetent venous valves

B) hyponatremia

C) inflammation

D) hypoproteinemia

B) Hyponatremia

Which of the following regulates the secretion of K⁺ into the filtrate?

A) Aldosterone

B) Parathyroid Hormone (PTH)

C) Antidiuretic Hormone (ADH)

D) Atrial Natriuretic Peptide (ANP)

A) Aldosterone

A patient is 72 years old and was admitted to the hospital for severe shortness of breath and edema to her lower extremities. She was diagnosed with heart failure. Which side of the heart failed, and how did this cause edema?

The right side of the heart failed, causing edema in her lower extremities. The failure to pump blood around the pulmonary circulation caused pooling of blood in the systemic circulation, leading to edema.

One of the major physiological factors that triggers thirst is ________.

a rise in plasma osmolality

What hormone reduces blood pressure and blood volume by inhibiting nearly all events that promote vasoconstriction and sodium ion and water retention?

Atrial Natriuretic Peptide (ANP)

Which of the following creates the greatest osmotic pressure?

A) glucose

B) KCl

C) NaCl

D) MgCl₂

D) MgCl₂

Which of the following hormones is important in the regulation of sodium ion concentrations in the extracellular fluid?

A) antidiuretic hormone

B) renin

C) erythropoietin

D) aldosterone

D) Aldosterone

What is the most abundant intracellular cation?

K+

Select the person in the following list who would have the highest percentage of water in his or her body.

A) a 25-year-old male of average weight

B) a 25-year-old overweight female

C) a 6-month-old baby boy

D) a 80-year-old man of average weight

C) a 6-month-old baby boy

Which of the following is NOT involved in triggering the thirst mechanism?

A) osmoreceptors detect increased osmolality

B) increase in blood pressure

C) decrease in blood volume

D) dry mouth

B) Increase in blood pressre

Which age group most commonly has fluid, electrolyte, and acid-base balance issues?

A) Young Adults

B) Infants

C) Growing children

D) The elderly

B) infants

Which of the following conditions promotes edema?

A) Diabetes Mellitus

B) Hyponatremia

C) hypoproteinemia

D) Hemorrhage

C) hypoproteinemia

Which of the following abnormalities would not be observed in a patient who has Addison's disease?

A) elevated blood plasma potassium level

B) hypertension

C) hyponatremia

D) decreased plasma chloride level

B) hypertension

**Hypertension (abnormally high blood pressure) is typically caused by restricting blood flow by vasoconstriction or abnormally high fluid volume in the blood. Water balance is regulated by anti-diuretic hormone secreted from the posterior pituitary.

What results from increased levels of aldosterone?

A) increased K⁺ reabsorption

B) increased Ca²⁺ reabsorption

C) increased Na⁺ reabsorption

D) decreased Na⁺ reabsorption

C) increased Na⁺ reabsorption

Under normal circumstances, most water is lost in __________.

Urine

What type of water imbalance increases the amount of fluid in all compartments?

Hypotonic hydration

Which of the following does NOT serve as a source of acids in the body?

A) Fat metabolism

B) Ingested foods

C) Aerobic breakdown of glucose

D) CO2 in the blood

C) Aerobic breakdown of glucose

The maintenance of the proper pH of the body fluids may be the result of ________.

the control of respiratory ventilation

Blood analysis indicates a low pH, and the patient is breathing rapidly. Given your knowledge of acid-base balance, which of the following is most likely?

metabolic acidosis

The single most important factor influencing potassium ion secretion is ___.

potassium ion concentration in blood plasma

In a given day, what is the typical value for water intake?

2500 ml

What receptors does the brain use to detect changes in osmolality?

Osmoreceptors

After traveling from Los Angeles to Denver, Claire finds she is not feeling well and checks into a clinic for help. What was the reason of her complaint, and what has caused this problem?

Respiratory alkalosis caused by hyperventilation. Claire was breathing faster and deeper due to stress.

The primary buffer of the extracellular fluid (ECF) is the ___.

bicarbonate buffer system

Which of the following statements is true regarding fluid shifts?

A) There are always more positive electrolytes than negative in a solution; it is therefore impossible to follow fluid shifts.

B) Electrolytes have greater osmotic power than nonelectrolytes and therefore have the greatest ability to cause fluid shifts.

C) Nonelectrolytes are the controlling factor in directing fluid shifts.

D) Electrolytes are not as important as proteins in regulating fluid shifts in the body.

B) Electrolytes have greater osmotic power than nonelectrolytes and therefore have the greatest ability to cause fluid shifts.

A falling blood pH and a rising partial pressure of carbon dioxide due to pneumonia or emphysema indicates ________.

Respiratory Acidosis

Which of the following is not a trigger for juxtaglomerular granular cells to release renin?

A) sympathetic stimulation

B) increased extracellular fluid water levels

C) decreased filtrate

D) NaCl concentration decreased stretch due to decreased blood pressure

B) Increased extracellular fluid water levels

This chemical equation shows the reaction of a strong acid and weak base in the bicarbonate buffer system. Provide the products of the following reaction. HCl + NaHCO₃ -->

H₂CO₃ + NaCl

Which buffer system if the most abundant in the body?

Protein

Edema

An atypical accumulation of fluid in the interstitial space

Hypoproteinemia

A condition of unusually low levels of plasma proteins resulting in tissue edema

Addisons Disease

A disorder entailing deficient mineralocortocoid hormone production by the adrenal cortex

Aldosterone

Regulates sodium ion concentrations in the extracellular fluid

Hyponatermia

A condition due to excessive water intake that results in net osmosis into tissue cells. This leads to severe metabolic disturbances.

Which of the following does not depend on the presence of electrolytes?

A) amount of body fat

B) membrane polarity

C) maintenance of osmotic relations between cells and ECF

D) neuromuscular excitability

A) Amount of body fat

What hormone helps to maintain extracellular fluid (ECF) osmolality when concentrations become too high?

Antidiuretic hormone (ADH)

The regulation of sodium ________.

is linked to blood pressure

What is the most abundant intracellular anion?

HPO₄ ^2-

What is the most important trigger for aldosterone release?

A) decreased sodium ion concentration in the extracellular fluids (ECF)

B) renin-angiotensin-aldosterone mechanism

C) increased osmolality of the extracellular fluids (ECF)

D) decreased K⁺ concentration in the extracellular fluids (ECF)

B) renin-angiotensin-aldosterone mechanism

Which of the following is not a disorder of water balance?

A) excessive hydration due to excess ANP secretion

B) excess water in interstitial spaces due to a low level of plasma proteins

C) hypotonic hydration, in which sodium content is normal but water content is high

D) edema or tissue swelling, which is usually due to an increased capillary hydrostatic pressure

A) excessive hydration due to excess ANP secretion

Hypermagnesemia

Magnesium excess

Hypocalcemia

Calcium depletion

Hypernatremia

Sodium excess

Hyperkalemia

potassium excess

Hyponatremia

Sodium depletion

Which of the following is NOT a hormone involved in water and electrolyte balance?

A) thyroxine

B) atrial natriuretic peptide

C) ADH

D) aldosterone

A) Thyroxine

How much water is generated per day from cellular metabolism?

250 ml

Which of the following describes the distribution of sodium and potassium between cells and body fluids?

A) equal amounts of each ion in the cells and body fluids

B) little of either in the cells, but large amounts of each in the body fluids

C) Na⁺ mainly in the cells, K⁺ in the body fluids

D) K⁺ mainly in the cells, Na⁺ in the body fluids

D) K⁺ mainly in the cells, Na⁺ in the body fluids

PTH (parathyroid hormone) acts on the ___ to ___ Ca²⁺ reabsorption.

Space 1. DCT

Space 2. increase

T/F: Potassium balance is controlled mainly by renal mechanisms.

TRUE

Starvation would cause which of the following acid-base conditions? Also, determine what type of compensation (metabolic or respiratory) there would be.

Metabolic acidosis with respiratory compensation

A patient is admitted to the hospital with the following plasma values: pH = 7.2, pCO₂ = 55 mmHg, and HCO_3¯ = 30 mEq/L. What is the acid base imbalance?

respiratory acidosis with metabolic compensation

A patient is admitted to the hospital with the following plasma values: pH = 7.5, pCO₂ = 45 mmHg, and HCO_3¯ = 30 mEq/L. What is the acid-base imbalance?

Metabolic alkalosis with no compensation

A patient is admitted to the hospital with the following plasma values: pH = 7.2, pCO₂ = 25 mmHg, and HCO_3¯ = 18 mEq/L. What is the acid base imbalance?

Metabolic acidosis with respiratory compensation

Diarrhea can lead to which acid/base disturbance? Assuming compensation, would it be a metabolic or respiratory compensation?

Metabolic acidosis with respiratory compensation

Emphysema can lead to which acid/base disturbance? What would be the compensation?

Respiratory acidosis; kidneys will retain more HCO_{3 and excrete H+}

What solute in body fluids determines most of their chemical and physical reactions?

Electrolytes

Of the three buffering mechanisms in the body, which is the strongest?

Renal System

The bicarbonate buffer system is one of the chemical buffer systems of the body. How would the bicarbonate buffer system work is Sodium hydroxide were added to a solution?

A hydrogen on carbonic acid would dissociate and join the hydroxyl group on the base to form water and sodium bicarbonate

The respiratory system is one of the 3 systems that regulate acid-base balance in the body. How does it work to decrease an acidosis?

Carbonic acid is broken down into water and CO₂; the CO₂ is then exhaled.

In respiratory acidosis the kidney would do which of the following?

A) The kidney would reabsorb bicarbonate and secrete hydrogen ions.

B) The kidney would increase excretion of both bicarbonate and hydrogen ions.

C) The kidney will reabsorb both bicarbonate and hydrogen ions. When it reabsorbs the hydrogen ion, it also generates more bicarbonate ions.

A) The kidney would reabsorb bicarbonate and secrete hydrogen ions.

Ingesting too much antacid would cause which of the following acid-base disturbances?

Metabolic alkalosis

Vomiting would cause which type of acid-base disturbance?

Metabolis Alkalosis

Severe anxiety would cause which type of acid-base disturbance? What would be the compensation?

Respiratory alkalosis

kidneys would excrete HCO₃

Which chemical buffer system is the only important system in the extracellular fluid (ECF) that resists short-term changes in pH?

bicarbonate buffer system

A decrease in blood CO₂ levels leads to __________.

an increase in blood pH

The fluid that bathes the cells found in tissues is called __________.

Interstitial Fluid

The term alkaline reserve is used to describe the ________ buffer system.

bicarbonate

Which of the choices below exerts primary control over sodium levels in the body?

A) aldosterone

B) water levels

C) glucocorticoids

D) ADH

A) Aldosterone

Where is the majority of water stored in the human body?

Intracellular Fluid (ICF) Compartment

A patient's anxiety caused her to develop respiratory alkalosis. What breathing technique did the nurse recommend, and why?

The nurse instructed the patient to breathe slower and deeper, and to breathe into a paper bag. This will increase the patient's blood level of carbon dioxide by eliminating less carbon dioxide from the lungs, and by breathing in the expired air which has a higher concentration of carbon dioxide. As a result, the blood pH will decrease.

Respiratory acidosis can occur when ________.

a person's breathing is shallow due to obstruction