2014 MBBS Exercises and review questions

Exercise for Disorders of Water and Electrolyte Metabolism

MCQs of type A

1. Which organ plays the key role in keeping sodium and water balance
of body?
(
)

A. Sweat gland

B. Skin

D. Kidney

E. Digestive tract

C. Lung

2. The main role of aldosterone is

)
A. To increase the excretion of sodium and the reabsorption of
potassium in renal tubule
B. To increase the excretion of sodium and potassium in renal
tubule
C. To increase the reabsorption of sodium and potassium in renal
tubule
D. To increase the reabsorption of sodium and the excretion of
potassium in renal tubule
E. To increase the excretion of sodium, potassium and water
3. The characteristic of hypovolemic hyponatremia is ( )
+
A. Serum Na concentration is increased, the volume of
extracellular fluid is decreased
+
B. Serum Na concentration is decreased, the volume of
extracellular fluid is increased
+
C. Serum Na concentration is decreased, the volume of
extracellular fluid is decreased
+
D. Serum Na concentration is decreased, the volume of
intracellular fluid is decreased

+
E. Serum Na concentration is increased, the volume of
intracellular fluid is decreased
4. Which one of the following disorders of water and sodium metabolism
induces peripheral circulatory failure easily? ( )
A. Hypertonic dehydration

B. Hypotonic dehydration

C. Isotonic dehydration

D. Water intoxication

E. Edema

5. Which one of the following is the main mechanism for local edema in
a person bitten by an insect?
(
)
A. Capillary hydrostatic pressure is increased
B. Plasma colloid osmotic pressure is decreased
C. Capillary permeability is increased
D. Lymphatic return is decreased
E. Plasma crystal osmotic pressure is decreased
6. Which one is the main mechanism of inflammatory edema?
(
)
A. Decreased plasma colloid osmotic pressure
B. Increased capillary permeability
C. Lymphatic obstruction
D. Increased ANP
E. Decreased GFR
Term explanations

1. hypovolemic hyponatremia(hypotonic dehydration,hypo-osmotic

dehydration)

2. edema

3. signs of dehydration

Short questions

1. Why doesn't shock occur easily in mild hypertonic dehydration?

2. Please describe the influences of edema on the body.

Exercise for Acid base disturbance

MCQs of type A

1. The acid substance in body fluid of a healthy person mainly is

)
A. The acid ingested with diet
B. Carbonic acid (H2CO3) formed by metabolism
C. Lactic acid produced by glycolysis
D. Inorganic acid generated by protein catabolism
E.-hydroxybutyric acid produced by fat metabolism

2. Which of the following plays a principal role in buffering volatile acid

)
A. Bicarbonate buffer system
B. Inorganic phosphate buffer system
C. Hemoglobin buffer system
D. Plasma protein buffer system
E. Organic phosphate buffer system
3. Which of the following is the most important mechanism of
compensation in acute metabolic acidosis? (
)
A. Regulation of blood buffer system
B. Regulation of intracellular buffer system
C. Pulmonary compensation
D. Renal compensation
E. Dissolution of bone phosphate
4. Which of the following is the most principal compensation on which
an individual with acute respiratory acidosis depends to regulate the
acid-base balance?
(
)
A. Buffer effect of red blood cells and tissue cells
B. Buffer effect of plasma buffer pairs
C. Pulmonary compensation
D. Renal compensation
E. Dissolution of calcium phosphate in bone

5. The results of blood gas analysis on the arterial blood from an

individual with diabetic ketoacidosis are: pH7.31, PaCO 2 32mmHg,
+
+
[HCO3 ] 16mmol/L, [Na ] 142mmolL[Cl ] 104mmol/L and [K ]
4.5mmol/L. What diagnosis of the following should be made?
(

A. Metabolic acidosis with a normal AG

B. Metabolic acidosis with an increased AG
C. Metabolic acidosis with an increased AG plus metabolic
alkalosis
D. Metabolic acidosis with a normal AG plus metabolic alkalosis
E. Normal state of acid-base balance
6. Metabolic acidosis with a normal AG can be seen in which of the
following situations?
(
)
A. CO intoxication
Uremia

B. Alcohol intoxication

D. Renal tubular acidosis

(

C.

E. Salicylic acid intoxication

7. Which of the following can lead to the increase of both AB and SB?
)
A. Acute respiratory acidosis
acidosis

B. Chronic respiratory

C. Acute respiratory alkalosis

alkalosis

D. Chronic respiratory

E. Acute metabolic acidosis

8. Which of the following is the main effect of acute respiratory acidosis
on the body? (
)
A. Decrease of myocardial contraction
C. Pulmonary encephalopathy
of bones
E. Hyperkalemia
Term explanations

1. metabolic acidosis

2. respiratory acidosis

B. Arrhythmias
D. Pathological changes

3. CO2 narcosis:

Short questions

1. Try to explain the roles of renal compensatory regulation in the body

with metabolic acidosis.

2. What are the influences of metabolic acidosis on cardiovascular

system?

3. Try to explain the mechanism by which metabolic acidosis can result

in inhibition of central nervous system (CNS) function.

Exercise for heart failure

MCQs of type A

1. Whichoneofthefollowingstatementsisthebestdescriptionofheartfailure?
A. Decreased cardiac output
B. Impaired diastolic function of the heart
C. Impaired systolic function of the heart
D.The inability of the heart to pump enough blood to meet the metabolic
requirements
E. Venous congestion, pulmonary edema, ascites or swelling of the feet
and legs

2. Highoutputheartfailureiscommonlyobservedin
A. Essential hypertension
B. Coronary artery disease
C. Heart valves disease
D. Severe anemia
E. Myocarditis

3. Which one of the following compensatory mechanisms cannot occur

after acute myocardial infarction?
(
)
A. Increased heart rate
B. Tonogenic dilatation
C. Increased sympathetic activity
D. Myocardial hypertrophy
E. Redistribution of blood flow

4.

Severe anemia usually leads to heart failure, its main mechanism may
be
A. Disorders in energy production
B. Disorders in energy utilization
C. Increased cardiomyocyte apoptosis
D. Increased cardiomyocyte necrosis
E. Disorders in energy store

5. Which one of the following changes often occurs in left heart failure?
A. Metabolic acidosis
B. Respiratory acidosis and metabolic acidosis
C. Respiratory acidosis
D. Respiratory alkalosis
E. Metabolic alkalosis

6. Concentric hypertrophy is usually caused by

A. Severe anemia
B. Hyperthyroidism
C. Severe deficiency of vitamin B1
D. Essential hypertension
E. Aortic valves incompetence

7. Which one of the following causes is associated with impaired energy

utilization during the development of excessive myocardial
hypertrophy? ( )

A.

Decreased sympathetic nervous density in the myocardium

B.
Impaired oxidative phosphorylation in mitochondria of hypertrophic
myocardium
C.

Less calcium released from the sarcoplasmic reticulum

D.

Decreased activity of myosin ATPase in hypertrophyic myocardium

E.
Decreased concentrations of norepinephrine in hypertrophyic
myocardium

8. Congestive heart failure refers to

(
)
A. Chronic heart failure
B. Heart failure characterized with increased volume load, edema
and ventricular stretch
C. Acute left heart failure
D. Systolic failure

E. Acute right heart failure

9. The pathogenesis of dyspnea in patients with left heart failure is

( )
A. Hypotension

B. Congestion of systemic circulation

C. Myocardial ischemia and hypoxia

volume

D. Increased blood

E. Pulmonary congestion and pulmonary edema

10. Which one of the following symptoms is mainly induced by left heart
failure?
( )
A. Pitting edema

B. Dyspnea

C. Liver tumefaction and tenderness

veins
E. Dysfunction of gastrointestinal tract
Term explanations

Heart failure Myocardial hypertrophy

Orthopnea

D. Engorgement of jugular

Paroxysmal nocturnal dyspnea

Long Questions

Explain the mechanisms of depressed myocardial contractility in heart

failure.

Please describe the cardiac compensation in the early stages of heart

failure.