1. **What is the normal range of arterial pH in the human body?

**
- a) 6.8 to 7.2
- b) 7.0 to 7.4
- c) 7.37 to 7.42
- d) 7.4 to 7.8

2. **Acidemia refers to an arterial pH:**

- a) Greater than 7.42
- b) Equal to 7.0
- c) Less than 7.37
- d) Between 7.37 and 7.42

3. **Which organ is primarily responsible for the excretion of volatile acids?**

- a) Kidneys
- b) Lungs
- c) Liver
- d) Skin

4. **What is the primary function of the bicarbonate buffer system?**

- a) To maintain blood glucose levels
- b) To buffer H+ ions and regulate pH
- c) To transport oxygen
- d) To facilitate digestion

5. **The major clinical effect of increased [H+] (acidosis) is:**

- a) Overexcitability of the nervous system
- b) Depression of the central nervous system (CNS)
- c) Enhanced enzyme activity
- d) Increased cardiac output

6. **Which condition is characterized by overexcitability of the nervous system due to decreased

[H+]?**
- a) Acidosis
- b) Alkalosis
- c) Hyperkalemia
- d) Hypocalcemia

7. **Fixed acids such as sulfuric acid and phosphoric acid are primarily excreted by the:**
- a) Lungs
- b) Skin
 - c) Kidneys
- d) Liver

8. **What role do buffers play in the body’s defense against pH changes?**

- a) Increase the production of acids
- b) Decrease the excretion of acids
- c) Neutralize excess acids and bases
- d) Promote acid production in the stomach

9. **Which of the following is a primary intracellular buffer?**

- a) Hemoglobin
- b) Bicarbonate
- c) Phosphate
- d) Ammonia

10. **The Henderson-Hasselbalch equation is used to calculate:**

- a) Blood pressure
- b) Body temperature
- c) pH of a buffered solution
- d) Oxygen saturation

11. **The pK value of the bicarbonate buffer system is:**

- a) 4.8
- b) 6.1
- c) 6.8
- d) 7.4

12. **Which buffer system is most important in the extracellular fluid?**

- a) Protein buffer system
- b) Hemoglobin buffer system
- c) Phosphate buffer system
- d) Bicarbonate buffer system

13. **In acid-base disorders, a respiratory cause is associated with abnormal levels of:**
- a) HCO3-
- b) H+
- c) CO2
- d) Na+

14. **Which mechanism provides the fastest response to acid-base imbalances?**

- a) Renal mechanisms
- b) Respiratory mechanisms
- c) Chemical buffer systems
- d) Hormonal mechanisms

15. **The reabsorption of bicarbonate in the kidneys primarily occurs in the:**

- a) Proximal tubule
- b) Distal tubule
 - c) Collecting duct
- d) Loop of Henle

16. **During alkalosis, the kidneys:**

- a) Excrete more HCO3-
- b) Retain more HCO3-
- c) Excrete more H+
- d) Retain more K+

17. **What is the major buffer system in red blood cells?**

- a) Bicarbonate buffer system
- b) Hemoglobin buffer system
- c) Phosphate buffer system
- d) Protein buffer system

18. **Excretion of H+ as NH4+ in the kidneys is an example of:**

- a) Respiratory regulation
- b) Renal compensation
- c) Chemical buffering
- d) Metabolic regulation

19. **The primary buffer for fixed acids in the urine is:**
- a) Ammonia
- b) Bicarbonate
- c) Phosphate
- d) Protein

20. **A pH lower than 7.37 indicates:**

- a) Alkalemia
- b) Acidemia
- c) Neutral pH
- d) Normal pH range

21. **Which enzyme catalyzes the conversion of CO2 and H2O to H2CO3?**
- a) Carbonic anhydrase
- b) Amylase
- c) Protease
- d) Lipase

22. **The main role of the respiratory system in acid-base balance is to:**
- a) Excrete H+
- b) Reabsorb bicarbonate
- c) Expel CO2
- d) Produce ammonia

23. **The normal plasma bicarbonate (HCO3-) concentration is:**

- a) 12-18 mEq/L
- b) 18-24 mEq/L
 - c) 22-28 mEq/L
- d) 28-34 mEq/L

24. **Which acid-base disorder is caused by an increase in CO2 levels?**

- a) Metabolic acidosis
- b) Metabolic alkalosis
- c) Respiratory acidosis
- d) Respiratory alkalosis

25. **What is the effect of hyperventilation on blood pH?**

- a) Decreases pH (acidosis)
- b) Increases pH (alkalosis)
- c) No effect on pH
- d) Neutralizes pH

26. **Which of the following is a volatile acid produced by the body?**

- a) Lactic acid
- b) Sulfuric acid
- c) Phosphoric acid
- d) Carbonic acid

27. **The kidney's ability to generate new bicarbonate is primarily associated with the:**
- a) Proximal tubule
- b) Distal tubule
- c) Collecting duct
- d) Loop of Henle

28. **Which condition results from excessive loss of bicarbonate through diarrhea?**
- a) Metabolic acidosis
- b) Metabolic alkalosis
- c) Respiratory acidosis
- d) Respiratory alkalosis

29. **The main consequence of untreated acidosis on the central nervous system is:**
- a) Overexcitability
- b) Depression
- c) Enhanced enzyme activity
- d) Increased metabolic rate

30. **What happens to plasma potassium levels during acidosis?**

- a) They increase
- b) They decrease
- c) They remain unchanged
- d) They fluctuate unpredictably

31. **In metabolic alkalosis, the respiratory system compensates by:**

- a) Increasing ventilation
- b) Decreasing ventilation
 - c) Increasing bicarbonate reabsorption
- d) Decreasing bicarbonate reabsorption

32. **Which condition is characterized by a primary decrease in bicarbonate (HCO3-) concentration?**

- a) Metabolic acidosis
- b) Metabolic alkalosis
- c) Respiratory acidosis
- d) Respiratory alkalosis

33. **Which buffer system operates in both extracellular and intracellular compartments?**
- a) Bicarbonate buffer system
- b) Protein buffer system
- c) Hemoglobin buffer system
- d) Phosphate buffer system

34. **How does the renal system respond to respiratory acidosis?**

- a) By increasing HCO3- reabsorption
- b) By decreasing HCO3- reabsorption
- c) By decreasing H+ secretion
- d) By increasing CO2 excretion

35. **What is the effect of renal failure on acid-base balance?**

- a) Respiratory acidosis
- b) Respiratory alkalosis
- c) Metabolic acidosis
- d) Metabolic alkalosis

36. **Which molecule is a strong acid?**

- a) HCl (hydrochloric acid)
- b) H2CO3 (carbonic acid)
- c) H3PO4 (phosphoric acid)
- d) NH4+ (ammonium)

37. **During metabolic acidosis, how does the body compensate through respiration?**
- a) Decreasing respiratory rate
- b) Increasing respiratory rate
- c) Decreasing tidal volume
- d) Increasing tidal volume

38. **Which of the following contributes to the buffering capacity of hemoglobin?**

- a) Presence of weak acid groups
- b) Presence of strong acid groups
- c) Ability to bind CO2
-

d) Ability to bind O2

39. **Which factor primarily determines the pH of a solution?**

 - a) Concentration of water
- b) Concentration of solutes
- c) Concentration of hydrogen ions (H+)
- d) Concentration of oxygen

40. **What is the clinical term for a state of abnormally high blood pH?**
- a) Alkalosis
- b) Acidosis
- c) Hyperkalemia
- d) Hypokalemia