BRS PHYSIOLOGY EXAM QUESTIONS AND ANSWERS VERIFIED GRADED A++ LATEST UPDATE
1. Secretion of K+ by the distal tubule will be decreased by
(A) metabolic alkalosis
(B) a high-K+ diet
(C) hyperaldosteronism
(D) spironolactone administration
(E) thiazide diuretic administration
The answer is D [V...
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BRS PHYSIOLOGY EXAM QUESTIONS AND ANSWERS
VERIFIED GRADED A++ LATEST UPDATE
1. Secretion of K+ by the distal tubule will be decreased by
(A) metabolic alkalosis
(B) a high-K+ diet
(C) hyperaldosteronism
(D) spironolactone administration
(E) thiazide diuretic administration
The answer is D [VB4b].Distal K+ secretion is decreased by factors that decrease the
driving force for passive diffusion of K+ across the luminal membrane. Because spirono-
lactone is an aldosterone antagonist, it reduces K+ secretion. Alkalosis, a diet high in
K+, and hyperaldosteronism all increase [K+] in the distal cells and thereby increase K+
secre- tion. Thiazide diuretics increase flow through the distal tubule and dilute the
luminal [K+] so that the driving force for K+ secretion is increased.
2. Subjects A and B are 70-kg men. Subject A drinks 2 L of distilled water, and
subject B drinks 2 L of isotonic NaCl. As a result of these ingestions, subject B
will have a
(A) greater change in intracellular fluid (ICF) volume
(B) higher positive free-water clearance
(CH2O)
(C) greater change in plasma osmolarity
,(D) higher urine osmolarity
(E) higher urine flow rate
TheanswerisD[IC2a;VIIC;Figure5-15;Table5-6].Afterdrinkingdistilledwater,sub- ject A will
have an increase in intracellular fluid (ICF) and extracellular fluid (ECF) vol- umes, a
decrease in plasma osmolarity, a suppression of antidiuretic hormone (ADH) secretion,
and a positive free-water clearance (CH2O), and will produce dilute urine with a high
flow rate. Subject B, after drinking the same volume of isotonic NaCl, will have an
increase in ECF volume only and no change in plasma osmolarity. Because subject B's
ADH will not be suppressed, he will have a higher urine osmolarity, a lower urine flow
rate, and a lower CH2O than subject A.
A 45-year-old woman develops severe diar- rhea while on vacation. She has the
following arterial blood values:
pH = 7.25
PcO2 = 24 mm Hg
[HCO3-] = 10 mEq/L
Venous blood samples show decreased blood [K+] and a normal anion gap.
3. The correct diagnosis for this patient is
(A) metabolic acidosis
(B) metabolic alkalosis
(C) respiratory acidosis
(D) respiratory alkalosis
(E) normal acid-base status
, The answer is A [IXD1a-c;Tables5-8and5-9].AnacidpH,togetherwithdecreased HCO3-
and decreased PCO2, is consistent with metabolic acidosis with respiratory com-
pensation (hyperventilation). Diarrhea causes gastrointestinal (GI) loss of HCO3-,
creating a metabolic acidosis.
A 45-year-old woman develops severe diar- rhea while on vacation. She has the
following arterial blood values:
pH = 7.25
PcO2 = 24 mm Hg
[HCO3-] = 10 mEq/L
Venous blood samples show decreased blood [K+] and a normal anion gap.
Which of the following statements about this patient is correct?
(A) She is hypoventilating
(B) The decreased arterial [HCO3-] is a result
of buffering of excess H+ by HCO3-
(C) The decreased blood [K+] is a result of exchange of intracellular H+ for extra-
cellular K+
(D) The decreased blood [K+] is a result of
increased circulating levels of aldosterone
(E) The decreased blood [K+] is a result of
decreased circulating levels of antidiuretic hormone (ADH)
The answer is D [IXD1a-c;Tables5-8and5-9].The decreased arterial [HCO3-] is caused
by gastrointestinal (GI) loss of HCO3- from diarrhea, not by buffering of excess H+ by
HCO3-. The woman is hyperventilating as respiratory compensation for metabolic
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