Chapter 26 PDF

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Exam Name___________________________________

MATCHING. Choose the item in column 2 that best matches each item in column 1.

Match the following: 1) Dissociate into ions in water.

A) Electrolytes

Answer: A B) Interstitial 2) Do not dissociate in solution. Answer: E 3) The main fluid compartment outside the cells. Answer: C

C) Extracellular D) Intracellular E) Nonelectrolytes

4) The main fluid compartment located within the cell. Answer: D 5) Fluid in the spaces between cells. Answer: B Match the following: 6) Magnesium excess.

A) Hyperkalemia

Answer: D B) Hypocalcemia 7) Calcium depletion. Answer: B 8) Sodium excess.

C) Hypernatremia D) Hypermagnesemia

Answer: C 9) Potassium excess.

E) Hyponatremia

Answer: A 10) Sodium depletion. Answer: E

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Match the following: 11) An atypical accumulation of fluid in the interstitial space. Answer: E 12) Fluid loss, either the loss of water or the loss of water and solutes together. Answer: D 13) A disorder entailing deficient aldosterone production by the adrenal cortex.

A) Hyponatremia B) Addison's disease C) Aldosterone D) Dehydration E) Edema

Answer: B 14) Regulates sodium ion concentrations in the extracellular fluid. Answer: C 15) A condition due to excessive water intake that results in net osmosis into tissue cells. This leads to severe metabolic disturbances. Answer: A Match the electrolyte composition for the following: 16) The concentration of sodium ions is highest in ________. Answer: C 17) The concentration of potassium ions is highest in ________.

A) Intracellular fluid B) Interstitial fluid C) Blood plasma

Answer: A 18) The concentration of phosphate ions is highest in ________. Answer: A 19) The concentration of bicarbonate ions is highest in ________. Answer: B 20) The concentration of protein anions is highest in ________. Answer: A

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Match the following: 21) Possibly caused by severe diarrhea or untreated diabetes mellitus. Answer: C

A) Metabolic alkalosis B) Respiratory alkalosis

22) Possibly occurring with emphysema, extreme obesity, or narcotic overdose. Answer: D

C) Metabolic acidosis D) Respiratory acidosis

23) Possibly caused by asthma, pneumonia, or a severe panic attack. Answer: B 24) Possibly caused by vomiting, use of diuretics, or use of antacids. Answer: A TRUE/FALSE. Write 'T' if the statement is true and 'F' if the statement is false.

25) Adipose tissue is one of the most hydrated of all tissues in the human body. Answer:

True

False

26) The most abundant cation in intracellular fluid is sodium. Answer:

True

False

27) Electrolytes determine most of the chemical and physical reactions of body fluids. Answer:

True

False

28) Solutes, regardless of size, are able to move freely between compartments because water carries them along the osmotic gradients. Answer:

True

False

29) The thirst center in the brain is located in the hypothalamus. Answer:

True

False

30) Dehydration can be caused by endocrine disturbances such as diabetes mellitus or diabetes insipidus. Answer:

True

False

31) It is impossible to overhydrate because people need as much water as they can drink to carry out ordinary body functions. Answer:

True

False

32) Water imbalance, in which output exceeds intake, causing an imbalance in body fluids, is termed dehydration. Answer:

True

False

33) Salts are lost from the body in perspiration and urine only. Answer:

True

False

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34) Excessive loss of water from the extracellular fluid (ECF) leads to a rise in osmotic pressure in the ECF which causes cells to shrink as water leaves by osmosis. Answer:

True

False

35) Although the sodium content of the body may be altered, its concentration in the ECF remains relatively stable because of immediate adjustments in water volume. Answer:

True

False

36) Sodium is pivotal to fluid and electrolyte balance and to the homeostasis of all body systems. Answer:

True

False

37) When aldosterone release is inhibited, sodium reabsorption cannot occur beyond the distal convoluted tubule. Answer:

True

False

38) Aldosterone stimulates the reabsorption of sodium while enhancing potassium secretion. Answer:

True

False

39) Some potassium ions are reabsorbed from the kidney filtrate via type A intercalated cells, a unique population of collecting duct cells. Answer:

True

False

40) Aldosterone is secreted in response to low extracellular potassium. Answer:

True

False

41) To remain properly hydrated, water intake must equal water output. Answer:

True

False

42) The main way the kidney regulates potassium ions is to excrete them. Answer:

True

False

43) Obligatory water loss occurs because humans always take in more fluids through eating and drinking than they need to maintain water balance. Answer:

True

False

44) Premenstrual edema may be due to enhanced reabsorption of sodium chloride. Answer:

True

False

45) Heavy consumption of salt substitutes high in potassium can present a serious clinical problem when aldosterone release is not normal. Answer:

True

False

46) Insensible water loss includes water lost in feces. Answer:

True

False

47) The two hormones responsible for the regulation of calcium are pituitary hormone and calcitonin. Answer:

True

False

48) Calcitonin targets the bones and causes the release of calcium from storage when serum calcium levels are low. Answer:

True

False 4

49) The normal pH of blood is 7.35- 7.45. Answer:

True

False

50) Most acidic substances (hydrogen ions) originate as by- products of cellular metabolism. Answer:

True

False

51) Weak acids are able to act as chemical buffering systems for the body because they only partially dissociate. Answer:

True

False

52) The phosphate buffer system is relatively unimportant for buffering blood plasma. Answer:

True

False

53) The single most important blood buffer system is the bicarbonate buffer system. Answer:

True

False

54) One of the most powerful and plentiful sources of buffers is the protein buffer system. Answer:

True

False

55) As ventilation increases and more carbon dioxide is removed from the blood, the hydrogen ion concentration of the blood decreases. Answer:

True

False

56) Carotid artery and aortic baroreceptors are involved in long term adjustment to total body sodium ion content. Answer:

True

False

57) Respiratory acidosis results when lungs are obstructed and gas exchange is inefficient. Answer:

True

False

58) Prolonged hyperventilation can cause alkalosis. Answer:

True

False

59) Thirst is normally triggered by hypothalamic osmoreceptors sensitive to a 1- 2% increase in plasma osmolality. Answer:

True

False

60) Blood acidity results in depression of the CNS, whereas blood alkalosis results in overexcitement of the CNS. Answer:

True

False

MULTIPLE CHOICE. Choose the one alternative that best completes the statement or answers the question.

61) The body's water volume is closely tied to the level of which of the following ions? A) sodium ions B) hydrogen ions C) calcium ions

D) potassium ions

Answer: A 62) The term hypotonic hydration refers to ________. A) a condition that may result from renal insufficiency or drinking excessive amounts of water B) a condition that is caused by high levels of sodium in the extracellular fluid compartment C) the feeling one might have after profuse sweating with exertion D) the unpleasant feeling people have after drinking too much liquor Answer: A

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63) When antidiuretic hormone (ADH) levels are low, ________. A) a small volume of concentrated urine is excreted B) nearly all of the filtered water is reabsorbed C) aquaporins are inserted into the collecting duct principal cell apical membranes D) most of the water reaching the collecting ducts is not reabsorbed Answer: D 64) Which of the following hormones is important in the regulation of sodium ion concentrations in the extracellular fluid? A) antidiuretic hormone B) aldosterone C) erythropoietin D) renin Answer: B 65) Atrial natriuretic peptide (ANP) is a hormone that is made in the atria of the heart. The influence of this hormone is to ________. A) enhance atrial contractions B) reduce blood pressure and blood volume by inhibiting sodium and water retention C) prevent pH changes caused by organic acids D) activate the renin- angiotensin mechanism Answer: B 66) Respiratory acidosis can occur when ________. A) a person consumes excessive amounts of antacids B) the kidneys secrete hydrogen ions C) a person's breathing is shallow due to obstruction D) a runner has completed a very long marathon Answer: C 67) Total body water is NOT a function of which of the following? A) amount of water ingested B) amount of body fat C) age D) body mass Answer: A 68) Which of the choices below is NOT an essential role of salts in the body? A) anabolism of lipids B) membrane permeability C) neuromuscular activity D) secretory activity Answer: A 69) Which of the choices below exerts primary control over sodium levels in the body? A) glucocorticoids B) ADH C) aldosterone

D) water levels

Answer: C 70) The fluid link between the external and internal environment is ________. A) interstitial fluid B) cerebrospinal fluid C) intracellular fluid Answer: D

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D) plasma

71) In a car accident, Jane suffered a chest injury that resulted in impaired breathing and respiratory acidosis. How will her body compensate for this imbalance? A) Kidneys eliminate carbon dioxide. B) Kidneys retain bicarbonate ions. C) Kidneys eliminate bicarbonate ions. D) Kidneys retain hydrogen ions. Answer: B 72) Whereas sodium is found mainly in the extracellular fluid, most ________ is found in the intracellular fluid. A) bicarbonate B) chloride C) potassium D) iron Answer: C 73) Which of the following describes the distribution of sodium and potassium between cells and body fluids? A) K+ mainly in the cells, Na+ in the 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) equal amounts of each ion in the cells and body fluids Answer: A 74) For bulk flow across capillary walls, ________. A) fluid runs into lymphatic capillaries that empty into the interstitial space B) hydrostatic pressure of the interstitial space returns fluid to the capillary C) hydrostatic pressure of blood forces nearly protein- free plasma out of the blood into the interstitial space D) osmotic pressure of plasma proteins pulls fluid from the capillary into the interstitial space Answer: C 75) The single most important factor influencing potassium ion secretion is ________. A) potassium ion concentration in extracellular fluid B) the pH of the intracellular fluid C) intracellular sodium levels D) the potassium ion content in the renal tubule cells Answer: A 76) Amphoteric molecules _______. A) can function as acids at low pH B) trigger pH imbalances and must be neutralized by buffers C) can function as bases at high pH D) can function as an acid or a base depending on the pH Answer: D 77) A falling blood pH and a rising partial pressure of carbon dioxide due to pneumonia or emphysema indicates ________. A) respiratory acidosis B) metabolic alkalosis C) metabolic acidosis D) respiratory alkalosis Answer: A 78) The movement of fluids between cellular compartments ________. A) is regulated by osmotic and hydrostatic forces B) requires active transport C) requires ATP for the transport to take place D) always involves filtration Answer: A

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79) What hormone reduces blood pressure and blood volume by inhibiting nearly all events that promote vasoconstriction and sodium ion and water retention? A) atrial natriuretic peptide (ANP) B) aldosterone C) antidiuretic hormone (ADH) D) thyroxine Answer: A 80) When a strong acid such as HCl is added to the carbonic acid buffer system, _________. A) more carbonic acid is formed B) carbonic acid is converted into bicarbonate C) hydrochloric acid is neutralized by sodium hydroxide D) the blood plasma pH is reduced Answer: A 81) Which of the following is NOT a chemical buffer system? A) protein B) nitrogen

C) bicarbonate

D) phosphate

Answer: B 82) 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 stretch of the granular cells of the afferent arterioles D) decreased filtrate NaCl concentration Answer: B 83) 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. Answer: B 84) Which of the following would describe nonelectrolytes? A) inorganic acids C) inorganic salts

B) organic bases D) polar covalent compounds

Answer: D 85) The maintenance of the proper pH of the body fluids may be the result of ________. A) the active secretion of OH- into the filtrate by the kidney tubule cells B) control of the acids produced in the stomach C) the operation of the various buffer systems in the stomach D) the control of respiratory ventilation Answer: D

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86) Which of the following is NOT a disorder of water balance? A) edema or tissue swelling, which is usually due to an increased capillary hydrostatic pressure B) excess water in interstitial spaces due to a low level of plasma proteins C) excessive hydration due to excess atrial natriuretic peptide (ANP) secretion D) hypotonic hydration, in which sodium content is normal but water content is high Answer: C 87) The regulation of sodium ________. A) is linked to blood pressure B) involves aldosterone, a hormone that increases sodium excretion in the kidneys C) involves hypothalamic osmoreceptor detection of ion concentration D) is due to specific sodium receptors in the hypothalamus Answer: A 88) 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? A) metabolic acidosis B) respiratory alkalosis C) metabolic alkalosis D) respiratory acidosis Answer: A 89) A patient is breathing slowly, and blood pH analysis indicates an abnormally high value. What is the likely diagnosis? A) respiratory alkalosis B) metabolic alkalosis C) respiratory acidosis D) metabolic acidosis Answer: B 90) Which of the following is NOT a likely source of hydrogen ions in blood plasma? A) anaerobic metabolism of glucose B) aerobic metabolism of glucose C) metabolism of proteins containing phosphorus D) metabolism of fats Answer: B 91) Annie has just eaten a large order of heavily salted French fries, some pickled eggs, and some cheese. How will consuming this much salt affect her physiology? A) She will experience hypotension. B) There will be a temporary increase in blood volume. C) There will be a shift in the pH of her body fluids to the higher side of the pH scale. D) It will cause a prolonged increase in the osmolality of the blood. Answer: B 92) The most important force causing net outward water flow across capillary walls is ________. A) intracellular hydrostatic pressure B) osmotic pressure of plasma proteins C) hydrostatic pressure of interstitial fluid D) hydrostatic pressure of capillary blood Answer: D 93) When the blood becomes acidic (acidosis) and bicarbonate ions have been depleted, new bicarbonate ions must be generated in the plasma. Which of the following is NOT a means for replenishing bicarbonate ions? A) Glutamine is metabolized by deamination, oxidation, and acidification. B) Bicarbonate ions are reclaimed by tubular reabsorption. C) Ammonium ions are excreted in urine. D) Buffered hydrogen ions are excreted in urine. Answer: B 9

94) The regulation of potassium balance ________. A) is not linked to sodium balance B) is accomplished mainly by hepatic mechanisms C) involves aldosterone- induced secretion of potassium D) includes renal secretion, but never absorption Answer: C 95) After completing a marathon on a particularly warm day, Dave consumes four liters of water. Soon after, he begins to feel nauseous and starts vomiting. What is likely happening to Dave? A) obligatory water loss B) hypoproteinemia; unusually low levels of plasma proteins C) hyponatremia; very low extracellular sodium ion concentration D) dehydration Answer: C 96) Mary finds that she regularly retains water at a certain point in the menstrual cycle. Which of the following is chemically similar to aldosterone, and like aldosterone, enhances NaCl reabsorption in the renal tubules? A) follicle- stimulating hormone B) progesterone C) luteinizing hormone D) estrogen Answer: D 97) Nancy is experiencing an acute panic attack. While hyperventilating, she remembers to open a paper bag and breathe into it. What is Nancy trying to prevent? A) respiratory acidosis B) respiratory alkalosis C) metabolic acidosis D) metabolic alkalosis Answer: B 98) If the thyroid and parathyroid glands are surgically removed, which of the following would go out of balance without replacement therapy? A) potassium ion levels B) calcium ion levels C) anion levels D) sodium ion levels Answer: B 99) Insufficient parathyroid hormone production in the body could result in ________. A) kidney stones B) muscle twitching C) muscle weakness D) cardiac arrhythmia Answer: B 100) In the case of edema, excess fluid is held in which fluid compartment(s)? A) blood plasma B) interstitial fluid C) intracellular fluid D) intracellular fluid and interstitial fluid Answer: B 101) Falling arterial blood pressure promotes ________. A) enhanced water loss in urine C) vasodilation

B) enhanced sodium ion loss in urine D) vasoconstriction

Answer: D

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102) An illness causes Doug to experience severe diarrhea and an accompanying loss of bicarbonate- rich secretions. How can this metabolic acidosis be compensated? A) hypoventilation B) increased renin secretion C) enhanced sodium ion loss in urine D) increased respiratory rate and depth Answer: D SHORT ANSWER. Write the word or phrase that best completes each statement or answers the question.

103) What provides the shortest- term mechanism for preventing acid- base imbalances in the body? The longest- term mechanism? Answer: Chemical buffers act within a fraction of a second to resist a pH change. The longest- term mec...