What is the kidneys' most important function?

(Answer to Q. 1)  ANS: D
The kidneys' main job is to reabsorb sodium, not excrete it. For this reason, and because sodium has a major role in maintaining fluid balance, the kidney places a greater priority on reabsorbing Na+ than on maintaining Cl, K+, or acid-base balance.

(Answer to Q. 2)  ANS: B
The expected compensatory response to metabolic alkalosis is hypoventilation (CO2 retention).

(Answer to Q. 3)  ANS: D
In cases of severe metabolic acidosis, intravenous infusion of sodium bicarbonate (NaHCO3) may be indicated.

(Answer to Q. 4)  ANS: B
Hyperventilation is the main compensatory mechanism for metabolic acidosis. The increased plasma H+ of metabolic acidosis is buffered by plasma HCO3, reducing the plasma HCO3, and thus the pH. Uncompensated metabolic acidosis suggests that a ventilatory defect must ex-ist.

(Answer to Q. 5)  ANS: A
With severe diabetic ketoacidosis, a very deep, gasping type of breathing develops, called Kuss-maul's respiration.

(Answer to Q. 6)  ANS: C
A value of 140 mEq/L for Na+, 105 mEq/L for Cl, and 24 mEq/L for HCO3, yielding an anion gap of 11 mEq/L (140 mEq/L  105 mEq/L + 24 mEq/L = 11 mEq/L). The normal anion gap range is 9 to 14 mEq/L.

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