Which of the following enhances urinary K+ excretion?
A. an osmotic diuresis
B. acute metabolic acidosis
C. hypoaldosteronism
D. decreased tubular flow rate
E. a water diuresis
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Question 2) Which of the following hormones plays an important role in keeping the plasma concentration of K+ within normal limits?
A. calcitriol
B. vasopressin
C. PTH
D. insulin
E. glucagon
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Question 3) A healthy individual, weighing 60 kg, is infused with 1 L of isotonic saline to which 20 mEq of K+ has been added. Following the infusion, the plasma K+ of this individual has increased from 3.5 mEq/L to 7.8 mEq/L.
What is the most likely explanation for the development of hyperkalemia in this individual?
A. shift of K+ from the ICF into the ECF
B. impaired renal excretion of K+
C. the increase in plasma K+ of 4.3 mEq/L is what is expected from the addition of 20 mEq/L of K+ to the ECF
D. contraction of the ECF volume
E. development of hyperosmolality
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Question 4) The kidneys maintain a constant plasma osmolality by regulating the excretion of which of the following?
A. glucose
B. Na+
C. creatinine
D. H2O
E. K+
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Question 5) Hyponatremia can sometimes be seen in individuals whose ECF volume is decreased by more than 10. Which of the following factors contributes to the development of hyponatremia in this situation?
A. decreased levels of ADH
B. elevated levels of natriuretic peptides
C. increased excretion of Na+ by the kidneys
D. reduced excretion of solute-free water by the kidneys
E. development of positive Na+ balance
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Question 6) A 78-year-old woman with congestive heart failure develops pitting edema of her legs. Compared with a healthy (i.e., euvolemic individual), what set of parameters would be expected in this woman?
Plasma volume ECF volume ECV
A.
B.
C.
D.
E.
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Question 7) A patient has polyuria and polydipsia, and the urine osmolality is 100 mOsm/kg H2O. The polyuria and polydipsia are not corrected by intravenous injection of ADH, nor does the exogenous ADH alter urine osmolality.
What is the most likely disorder in this patient?
A. SIADH (syndrome of inappropriate ADH secretion)
B. osmotic diuresis
C. central diabetes insipidus
D. nephrogenic diabetes insipidus
E. nephrolithiasis (renal stone)
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Question 8) A 45-year-old woman has a blood pressure of 140/90 mm Hg. Her doctor recommends a low-salt diet. What would you predict her serum Na+ and ECF volume would be compared with their values on her previous diet?
(Note: Assume she has reached a new steady state on her new diet.)
Serum Na+ ECF volume
A. No change
B. No change No change
C. No change
D. No change
E.
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Question 9) Which of the following maneuvers would be expected to stimulate ADH secretion?
A. infusion of 1 L hypertonic NaCl
B. infusion of 1 L of an iso-osmotic urea solution
C. expansion of the ECV
D. infusion of 1 L of D5W
E. an acute increase in blood pressure
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Question 10) Which of the following will occur with a decrease in the ECF volume?
A. increase in GFR
B. increase in angiotensin II levels
C. increase in natriuretic peptide levels
D. increase in free H2O clearance
E. increase in fractional excretion of Na+
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