1 INCORRECT

Where is most water found in the body? A) B) C) blood plasma whole blood tissue spaces

in cells D) Feedback: Incorrect: Plasma is only fraction of the extracellular fluid.

2 INCORRECT

Which of these is a transcellular fluid? A) B) C) plasma lymph interstitial

synovial D) Feedback: Incorrect: Transcellular fluid is fluid that is located within areas separated from others by epithelial or other membranes, such as synovial or the aqueous humor of the eye.

3 INCORRECT

Which of these is not a transcellular fluid? A) B) C) interstitial fluid vitreous humor peritoneal fluid

mucus D) Feedback: Incorrect: Any fluid outside of cells is considered extracellular, such as interstitial fluid between cells, but some of these such as serous fluid are transcellular.

4 INCORRECT

Which of these is relatively high in extracellular fluids? A) B) C) potassium calcium phosphate

sodium D) Feedback: Incorrect: Because of selective membrane permeability, the concentrations of ions such as K+ are higher inside cells than Na+.

5 CORRECT

What is the main force that causes water to move among the various fluid compartments?

A) B) C)

osmosis filtration hydrostatic pressure

dialysis D) Feedback: Correct Answer: The concentration differences between cells and extracellular compartments creates osmotic pressure differences.

6 CORRECT

What is the main force that causes fluid to leave the plasma compartment? A) B) C) osmosis hydrostatic pressure dialysis

filtration D) Feedback: Correct Answer: Since the hydrostatic pressure component of blood pressure is always slightly higher than the plasma osmotic pressure, some water is constantly lost from the capillaries.

7 CORRECT

How is the excess tissue fluid mainly returned to the blood? A) B) C) hydrostatic forces through the capillaries lymphatic vessels

tissue osmosis D) Feedback: Correct Answer: The lymphatic system is a one-way network of vessels that captures the lost fluids around the cells and returns them to the subclavian veins.

8 INCORRECT

About _____% of the total daily intake of water is derived from internal cell metabolism. A) B) C) 33 10 80

60 D) Feedback: Incorrect: About 10% of daily water is an end product of cellular respiration as metabolic water; about 60% is obtained from drinking.

9 CORRECT

What is the greatest regulator of water intake? renal function

A) B) C) gastrointestinal system adequate diet

hypothalamus D) Feedback: Correct Answer: Thirst is the greatest regulator of water intake and is controlled in all animals by neurological centers in the hypothalamus and limbic system.

10 CORRECT

As total body water decreases, the _____ of the extracellular fluid increases. A) B) C) amount of sodium osmotic pressure hydrostatic pressure

protein level D) Feedback: Correct Answer: As fluid is lost, the concentration of particles increases, raising the osmotic pressure.

11 CORRECT

The greatest amount of body water is lost through _____. A) B) C) sweating defecation urine

breathing D) Feedback: Correct Answer: Assuming that a person is well and not engaging in strenuous activity, the kidneys are the usual method of excreting excess water.

12 CORRECT

The main factor that causes the kidney to conserve water is _____. A) B) C) ADH osmosis renin production

plasma filtration pressure D) Feedback: Correct Answer: Antidiuretic hormone increases the permeability and absorption of water at the distal convoluted tubules of the nephrons.

13 CORRECT

ADH is secreted from the _____. A) B) hypothalamus posterior pituitary

C)

anterior pituitary

kidney D) Feedback: Correct Answer: Although produced by the hypothalamus, ADH is stored and secreted into the blood from the posterior lobe of the pituitary.

14 CORRECT

Which of the following would have a diuretic effect? A) B) C) eating salty pretzels drinking alcohol sleeping

most drugs D) Feedback: Correct Answer: Alcohol (ethanol) has a profound effect as an anti-ADH agent that greatly increases urine output (diuresis); only some drugs have a diuretic effect.

15 CORRECT

ADH has a direct effect on _____. A) B) C) blood pressure water reabsorption blood concentration

all of these D) Feedback: Correct Answer: All body mechanisms are inter-related and affect multiple parameters; it is impossible to alter water levels without having some effect on pressure or concentration.

16 CORRECT

Excessive vomiting usually results in the phenomenon of _____. A) B) C) water intoxication dehydration edema

hypoproteinemia D) Feedback: Correct Answer: Although the fluid lost from the gastrointestinal system is extracellular, fluid will also belost from the blood because this loss must be replaced.

17 CORRECT

The symptoms of dehydration result from loss of _____ water. A) B) C) intracellular extracellular blood

transcellular D) Feedback: Correct Answer: Although the loss may be caused by extracellular changes, the alteration in CNS activity such as confusion and coma, result from direct changes in the intracellular compartment.

18 CORRECT

The effects of water intoxication are usually related to _____. A) B) C) blood pressure hypoproteinemia low sodium

high potassium D) Feedback: Correct Answer: The hypotonic water causes the concentration of Na+ to fall to levels that are not favorable for normal nerve and muscle conductivity and contraction.

19 INCORRECT

Which of the following favor the development of edema? A) B) C) hypoproteinemia decreased venous pressure decreased capillary permeability

lymphatic flow D) Feedback: Incorrect: Decreased capillary permeability favors water retention.

20 CORRECT

Which of these is not a usual cause of hypoproteinemia? A) B) C) glomerulonephritis poor diet diuresis

liver disease D) Feedback: Correct Answer: Urine output does not normally affect blood protein because the kidneys are only permeable to protein in diseases such as glomerulo-nephritis; the liver synthesizes protein.

21 CORRECT

What can be a direct cause of ascites? A) B) C) hypertension hepatic disease glomerulonephritis

renal failure D) Feedback: Correct Answer: Since ascites is excess fluid in the peritoneal cavity, it is usually caused by diseases that affect venous return to the heart such as liver cirrhosis or heart failure.

22 CORRECT

What causes the edema seen in inflammations? A) B) C) hyperproteinemia histamine hypertension

cell damage D) Feedback: Correct Answer: Cell damage initiates the inflammatory reaction which includes the release of vasoactive substances such as histamine which then evoke the increase in tissue fluids.

23 INCORRECT

Which of the following is not true in Addison's disease? A) B) C) sodium decreases potassium decreases adrenal cortex failure

low aldosterone D) Feedback: Incorrect: Sodium levels are characteristically lower.

24 CORRECT

Where are most electrolytes normally lost? A) B) C) feces sweating urine

respiration D) Feedback: Correct Answer: Although sweating during strenuous activity can cause a drastic loss of electrolytes, the normal control mechanism is the kidneys.

25 INCORRECT

What is the most abundant extracellular cation? A) B) C) potassium Mg2+ chloride

sodium D) Feedback: Incorrect: K+ is most abundant on the inside of cells.

26 CORRECT

Which factor accounts for the ability of the body to conserve high levels of sodium? A) B) C) blood pressure aldosterone kidney function

adequate diet D) Feedback: Correct Answer: Aldosterone is the hormone from the adrenal gland which causes the kidneys to reabsorb sodium on demand.

27 CORRECT

Which ion is usually exchanged for sodium absorption? A) B) C) Clbicarbonate K+

H+ D) Feedback: Correct Answer: Aldosterone will cause an increase in the reabsorption of sodium, which drives the membrane pump to eliminate potassium at an even higher rate in the kidneys.

28 CORRECT

Which cells are most sensitive to electrolyte changes? A) B) C) osteoblasts epithelial leukocytes

neurons D) Feedback: Correct Answer: Nerve and muscle cells are most sensitive to ion changes and must be maintained at stable levels for normal conductivity or contraction.

29 CORRECT

Which of these is not an effect of parathyroid hormone? A) B) C) osteoclast stimulation increase in blood Ca2+ increase in renal elimination

increase in intestinal absorption D) Feedback: Correct Answer: PTH causes the kidneys to retain Ca2+; the net effect is to raise blood calcium levels.

30 CORRECT

Which ion is directly related to calcium homeostasis? A) B) C) Mg2+ sodium phosphate

chloride D) Feedback: Correct Answer: There are mechanism involving hormones that usually maintain calcium and phosphate at inverse levels.

31 CORRECT

Hyperparathyroidism usually causes an increase in _____. A) B) C) potassium calcium phosphate

sodium D) Feedback: Correct Answer: Hyperparathyroidism causes an increase in PTH which causes calcium to be conserved.

32 INCORRECT

Which of the following does not become involved with maintaining blood calcium balance? A) B) C) skeletal muscle bone kidneys

intestine D) Feedback: Incorrect: Although muscle tissue uses Ca2+ in its reactions, as other tissues, it lacks the ability to regulate blood levels.

33 CORRECT

Which of the following is not related to hypocalcemia? A) B) C) vitamin D deficiency muscle weakness tetany

cardiac arrhythmia D) Feedback: Correct Answer: Muscle weakness is usually associated with the cellular imbalance of calcium associated with hypercalcemia.

34 INCORRECT

Which is the most abundant extracellular ion?

A) B) C)

phosphate bicarbonate chloride

potassium D) Feedback: Incorrect: Potassium is an abundant intracellular cation.

35 CORRECT

What is the most important ion, which affects all of the functions of the others? A) B) C) H+ Na+ K+

phosphate D) Feedback: Correct Answer: The H+ ion or acidity is the most important ion that has the capability of interacting with the other ions; pH balance is essential for proper enzyme functioning.

36 CORRECT

Which of the following will not produce H+ ions? A) B) C) respiration of glucose oxidation of fatty acids synthesis of phosphoproteins

oxidation of sulfur amino acids D) Feedback: Correct Answer: Catabolic reactions that involve oxidation usually result in acidic end products; the synthesis of proteins or other substances may not produce H+.

37 CORRECT

Which of these is not associated with acidity? A) B) C) H3PO4 lactic ketone

glucose D) Feedback: Correct Answer: Glucose will not produce an acidic solution, but lactic acid, some ketones, and phosphoric acid will produce H+.

38 CORRECT

What is a likely cause of hypernatremia? A) B) C) high salt in the diet kidney failure diabetes insipidus

vomiting D) Feedback: Correct Answer: In diabetes insipidus there is excess water loss through urination from a deficiency of ADH; vomiting could cause a depletion of sodium.

39 INCORRECT

Hypokalemia could result from all of these except which one? A) B) C) vomiting Addison's disease Cushing's disease

renal failure D) Feedback: Incorrect: Cushing's disease involves an excess of aldosterone while Addison's disease causes a deficiency; potassium is usually lost as sodium is conserved.

40 CORRECT

Which of the following acts as a base in body fluids? A) B) C) H+ HCl H2CO3

HCO3D) Feedback: Correct Answer: Bicarbonate anions (HCO3-) can bind to H+ in physiologic fluids, making it act as a base.

41 CORRECT

Which of the following does not play a significant role in maintaining acid-base balance? A) B) C) blood buffers stomach kidney

respiration D) Feedback: Correct Answer: Although the acidic pH of the stomach has a significant effect on blood pH, the stomach cannot maintain blood balance.

42

INCORRECT

Which of the following could act as a buffer? A) B) C) bicarbonate ion H2PO4 albumin

carbonic acid D) Feedback: Incorrect: Buffers must have two components, bicarbonate is the relative base.

43 CORRECT

The purpose of a buffer system is to _____. A) B) C) prevent pH changes increase acidity decrease pH

maintain a pH range D) Feedback: Correct Answer: Buffers contain components that stabilize pH under conditions of added bases or acids within ranges, but do not prevent changes.

44 INCORRECT

In the bicarbonate buffer system, _____ reacts with bases. A) B) C) carbon dioxide carbonic acid bicarbonate ion

water D) Feedback: Incorrect: Carbon dioxide reacts with water.

45 INCORRECT

When a strong base reacts with the bicarbonate buffer system, ______ is formed from the base. A) B) C) water carbon dioxide bicarbonate ion

carbonic acid D) Feedback: Incorrect: If one were to trace the OH- base in NaOH, it would end up as HOH or water and therefore, now as water, cannot effect pH alteration.

46 CORRECT

When an acid reacts with the bicarbonate buffer system, ______ is formed as an end product. NaCl

A) B) C) water carbonic acid

bicarbonate ion D) Feedback: Correct Answer: In this buffer reaction, the strong acid has been converted to carbonic acid which effectively lowers the potential to release H+, because it is weak (has a strong H+ bond).

47 CORRECT

What happens to HCl in the phosphate buffer reaction? A) B) C) ionizes forms water forms H2PO4

forms a weak acid and salt D) Feedback: Correct Answer: The HCl reacts to form NaCl and NaH2PO4.

48 INCORRECT

What reacts with excess acids in protein buffers? A) B) C) carboxyl group amino group CO2

NH3+ D) Feedback: Incorrect: The carboxyl group is the acidic portion.

49 CORRECT

What reacts with the excess bases in protein buffers? A) B) C) NH2 carbon dioxide NH3+

carboxyl group D) Feedback: Correct Answer: Both the carboxyl and amino groups could function as acids or bases; NH3+ reacts with OH- to form NH2 and water.

50 INCORRECT

What buffers the addition of hydrogen in blood cells following the uptake of carbon dioxide? albumin

A) B) C) bicarbonate hemoglobin

phosphate D) Feedback: Incorrect: Bicarbonate is not a significant RBC buffer.

51 CORRECT

Which factor greatly increases the reaction between carbon dioxide and water? A) B) C) carbonic anhydrase concentration of carbon dioxide concentration of bicarbonate

pH of hemoglobin D) Feedback: Correct Answer: Carbonic anhydrase is the enzyme found in the erythrocyte membrane which increases the reaction more than 100,000 times.

52 INCORRECT

Which of the following is an effect of acidosis? A) B) C) increased diuresis decreased diuresis mental confusion

seizures D) Feedback: Incorrect: Alkalosis tends to make neurons more excitable tending towards seizures while acidosis causes CNS depression leading to coma.

53 CORRECT

Which blood parameter is directly affected by breathing? A) B) C) blood pH carbon dioxide bicarbonate levels

buffer chemicals D) Feedback: Correct Answer: Breathing directly alters blood levels of carbon dioxide which then leads to changes in pH.

54 INCORRECT

During periods of acidosis, the kidney will secrete _____ into the urine. A) B) carbon dioxide K+

C)

H2PO4

HPO4 D) Feedback: Incorrect: HPO4 acts as a base.

55 INCORRECT

In an attempt to remove acid from the blood, the kidneys will secrete _____ into the urine compartment. A) B) C) ammonia NH4+ chloride

monohydrogen phosphate D) Feedback: Incorrect: Ammonium cations (NH4+) were formed from a combination of ammonia and H+.

56 INCORRECT

Which mechanism requires the most time to regulate pH? A) B) C) bicarbonate buffer phosphate buffer respiration

renal function D) Feedback: Incorrect: The blood chemical buffers operate instantly while respiration may require several minutes to adjust pH; the kidneys require 12-24 hours to completely adjust pH.

57 CORRECT

Which condition is a generalized accumulation of body edematous tissues? A) B) C) azotemia anuria acetonemia

anasarca D) Feedback: Correct Answer: Anasarca is a descriptive term for generalized edema; anuria is the cessation of urine production and azotemia is an excess of blood nitrogenous wastes.

58 CORRECT

What is the normal pH of the blood? A) B) 7.40-7.50 7.35-7.45

C)

6.8-7.9

7.0-8.0 D) Feedback: Correct Answer: The buffer systems maintain the pH range of the blood within narrow limits of 7.35-7.45.

59 INCORRECT

What is the pH range compatible with life? A) B) C) 7.35-7.45 7.0-9.0 6.8-8.0

5-9 D) Feedback: Incorrect: Persons cannot survive long with pH values under 6.8 or over 8.0.

60 INCORRECT

Hyperventilation from anxiety usually causes _____. A) B) C) respiratory acidosis metabolic acidosis respiratory alkalosis

metabolic alkalosis D) Feedback: Incorrect: Breathing eliminates CO2.

61 INCORRECT

Lung cancer usually causes the tendency towards _____. A) B) C) metabolic acidosis metabolic alkalosis respiratory acidosis

respiratory alkalosis D) Feedback: Incorrect: Any disease or condition that causes interference with the gas exchange in the lungs will cause a buildup of carbon dioxide.