Acid-base balance MCQ 67+

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• Raised serum HC03- concentration found in
  ক

  Metabolic alkalosis

  খ

  Respiratory acidosis

  গ

  Respiratory alkalosis

  ঘ

  Metabolic acidosis

  ঙ

  Renal failure
• Hypochloremic acidosis occurs in
  ক

  Addison's disease [Davidson’s/24th/P-685]

  খ

  Diarrhea and vomiting

  গ

  Renal tubular acidosis

  ঘ

  Diabetic ketoacidosis

  ঙ

  Acetazolamide treatment
• In type -2 or proximal renal tubular acidosis
  ক

  Urinary acidification occurs in collecting duct

  খ

  There is hypokalemia

  গ

  PCT fails to secrete hydrogen ions -

  ঘ

  There is reabsorption of bicarbonate ions

  ঙ

  Urinary pH is > 5.5
• Renal tubular acidosis may presents with
  ক

  Failure to thrive

  খ

  Polyuria

  গ

  Polydipsia

  ঘ

  Anemia

  ঙ

  Hypertension
• Features of renal tubular acidosis are
  ক

  Acidosis

  খ

  Hypokalemia

  গ

  Hypercholremia

  ঘ

  Hyperkalemia

  ঙ

  Increased anion gap
• Proximal renal tubular acidosis may be associated with
  ক

  Aminoaciduria

  খ

  Renal glycosuria

  গ

  An inability to lower the urinary pH

  ঘ

  Hypercalciuria

  ঙ

  Hyperkalaemia
• Cause(s) of distal renal tubular (type I) acidosis is (are)
  ক

  Sjogren's syndrome

  খ

  Lithium therapy

  গ

  Amyloidosis

  ঘ

  Hypoaldosteronism

  ঙ

  Carbonic anhydrase inhibitors
• High anion gap metabolic acidosis due to
  ক

  Ketoacidosis

  খ

  Methanol poisoning

  গ

  Lactic acidosis

  ঘ

  Diarrhea

  ঙ

  Hypokalemia
• Plasma anion gap is
  ক

  Increased in lactic acidosis

  খ

  Difference between measured cation and anion in urine

  গ

  Difference between unmeasured cation and anion in plasma

  ঘ

  It is 25-35 meq/L

  ঙ

  Decreased in renal failure
• Causes of high anion gap
  ক

  Ethylence glycol intoxication

  খ

  Hypovolemic shock

  গ

  Salicylate intoxication

  ঘ

  Renal tubular acidosis

  ঙ

  Diarrhoea
• Plasma anion gap is increased in
  ক

  Renal failure

  খ

  Ketoacidosis

  গ

  Lactic acidosis

  ঘ

  Renal tubular acidosis

  ঙ

  Diarrhea
• Anion gap is increased in
  ক

  Methanol poisoning

  খ

  Diabetic ketoacidosis

  গ

  Salicylate poisoning

  ঘ

  Acute watery diarrhoea

  ঙ

  Renal tubular acidosis
• Etiology of high anion gap metabolic acidosis are
  ক

  Lactic acidosis

  খ

  Alcohol poisoning

  গ

  Diarrhoea

  ঘ

  Renal tubular acidosis

  ঙ

  Hypoaldosteronism
• Respiratory acidosis occurs in
  ক

  Bronchial asthma

  খ

  COPD

  গ

  Severe chest injury

  ঘ

  High altitude

  ঙ

  Hyperventilation
• Causes of respiratory alkalosis include
  ক

  Pregnancy

  খ

  Gram negative sepsis

  গ

  Pulmonary embolism

  ঘ

  Hypoventilation

  ঙ

  Myasthenic crisis
• Respiratory alkalosis is characterized by
  ক

  Fall in PCO2

  খ

  Fall in bicarbonate concentration

  গ

  An increased HCO3-/PCO2 ratio

  ঘ

  Low PH

  ঙ

  Low anion gap
• Prolonged hyperventilation may lead to respiratory alkalosis which is associated with
  ক

  Lowering of plasma [HCO3]

  খ

  Lowering of plasma [Ca++]

  গ

  Lowering of plasma PCO2

  ঘ

  Increased renal reabsorption of HCO3

  ঙ

  Increased renal excretion of ammonium
• Respiratory alkalosis differs from metabolic alkalosis by the following
  ক

  Reduction in cerebral blood flow is greater

  খ

  HCO-3 is normal or low

  গ

  PCO2 is reduced

  ঘ

  Likelihood of tetany is less

  ঙ

  Urine is alkaline
• Followings are the causes of respiratory alkalosis.
  ক

  Voluntary hyperventilation

  খ

  While exposed to high altitude

  গ

  Laryngospasm

  ঘ

  Chronic obstructive airway disease

  ঙ

  Chronic renal failure
• A patient with carbon-dioxide retention is likely to have
  ক

  Raised cerebral blood flow

  খ

  Raised plasma bicarbonate

  গ

  Metabolic acidosis

  ঘ

  Alkaline urine

  ঙ

  Cool extremities
• Causes of respiratory alkalosis are
  ক

  High altitude

  খ

  Salicylate poisoning

  গ

  Vocal cord paralysis

  ঘ

  Hypothermia

  ঙ

  Hypoventilation
• Respiratory alkalosis differs from metabolic alkalosis by the following features
  ক

  HCO3- is normal or low

  খ

  PCO2 is reduced

  গ

  Greater reduction in cerebral blood flow

  ঘ

  Tetany is less

  ঙ

  Urine is alkaline
• Feature/s of respiratory alkalosis is/are
  ক

  Hypokalemia

  খ

  Low CO2

  গ

  Rapid shallow respiration

  ঘ

  Hypotension

  ঙ

  Low O2
• Recognized features of metabolic alkalosis include
  ক

  A decrease in renal excretion of H+ ion

  খ

  A increase in plasma bicarbonate level

  গ

  Hypoalbuminemia

  ঘ

  Hyperglycemia

  ঙ

  Hyponatremia
• In metabolic alkalosis
  ক

  Respiratory compensation results in a markedly raised PCO2

  খ

  Prolonged vomiting may be the cause

  গ

  Base excess is more than 2 mmoI/L

  ঘ

  ECF volume overload is a frequent finding

  ঙ

  Potassium concentration is often high
• Chloride responsive metabolic alkalosis occurs in
  ক

  Prolonged vomiting

  খ

  Prolonged diuretic therapy

  গ

  Cystic fibrosis

  ঘ

  Primary hyperaldosteronism

  ঙ

  Cushing’s syndrome
• Metabolic alkalosis results from
  ক

  Prolonged vomiting

  খ

  Excess mineralocorticoids

  গ

  Diarrhea

  ঘ

  Ureterosigmoidostomy

  ঙ

  Massive blood transfusion
• Alkalosis results from
  ক

  Persisting vomiting

  খ

  Cushing’s syndrome

  গ

  Conn’s syndrome

  ঘ

  Alcoholism

  ঙ

  Hypoaldosteronism
• Alkalosis may result from
  ক

  Persisting vomiting

  খ

  Cushing’s syndrome

  গ

  Hyperventilation

  ঘ

  Hypoaldosteronism

  ঙ

  Alcoholism
• Causes of metabolic alkalosis are
  ক

  Diuretic abuse

  খ

  Excessive vomiting

  গ

  Laxative

  ঘ

  Fanconi anaemia

  ঙ

  Paracetamol poisoning