front 1 A researcher estimates daily water gain in a fasting patient receiving dextrose-containing fluids. Which pairing correctly identifies the two major sources by which water enters body fluids? A) Sweat absorption; lipid oxidation B) Ingestion; carbohydrate oxidation C) Urine recycling; protein oxidation D) Fecal uptake; ketone oxidation | back 1 B. Ingestion; carbohydrate oxidation |
front 2 A sleeping patient loses water continuously from the respiratory tract without noticing it. What best explains why this is called insensible water loss? A) It occurs without conscious awareness B) It requires renal excretion C) It occurs only during fever D) It requires visible sweating | back 2 A. It occurs without conscious awareness |
front 3 A burn patient develops major ongoing fluid loss despite no diarrhea or polyuria. Which mechanism best explains this increased evaporative loss? A) Plasma protein overproduction B) Denuded cornified skin layer C) Reduced capillary membrane pores D) Increased intracellular fluid volume | back 3 B. Denuded cornified skin layer |
front 4 A patient with extensive burns is being resuscitated after losing large amounts of water by evaporation. Which route is usually required to balance this fluid loss? A) Intravenous fluid replacement B) Oral salt restriction C) Subcutaneous water injection D) Respiratory humidifier alone | back 4 A. Intravenous fluid replacement |
front 5 A person notices dry airways during cold weather. Which mechanism best explains this respiratory dryness? A) Higher vapor pressure increases humidification B) Low vapor pressure increases lung water loss C) Cold air stops respiratory evaporation D) Sweat production replaces lung loss | back 5 B. Low vapor pressure increases lung water loss |
front 6 In cold weather, atmospheric vapor pressure approaches zero. What effect does this have on respiratory water balance? A) Decreases lung water loss B) Increases lung water loss C) Stops insensible water loss D) Converts loss into sweat | back 6 B. Increases lung water loss |
front 7 A patient with severe diarrhea loses several liters of water daily. Why can this become life-threatening within days? A) Plasma proteins immediately disappear B) Fecal water loss can massively increase C) Urine volume must reach zero D) Intracellular water cannot shift | back 7 B. Fecal water loss can massively increase |
front 8 A physiology student is dividing total body fluid into its two main compartments. Which pair is correct? A) Plasma; transcellular fluid B) Blood; lymphatic fluid C) Extracellular fluid; intracellular fluid D) Interstitial fluid; cerebrospinal fluid | back 8 C. Extracellular fluid; intracellular fluid |
front 9 A student further divides extracellular fluid into its major subcompartments. Which pair is correct? A) Interstitial fluid; plasma B) Cytosol; red cell water C) Synovial fluid; intraocular fluid D) Plasma; intracellular fluid | back 9 A. Interstitial fluid; plasma |
front 10 A physician explains that synovial, peritoneal, pericardial, intraocular, and cerebrospinal fluids belong to a specialized compartment. Which classification is most accurate? A) Intracellular fluid subtype B) Specialized extracellular fluid C) Red blood cell fluid D) Plasma protein compartment | back 10 B. Specialized extracellular fluid |
front 11 Which set consists entirely of transcellular fluids? A) Plasma; lymph; sweat B) Cytosol; erythrocyte water; plasma C) CSF; synovial; pericardial fluid D) Interstitial; intracellular; extracellular fluid | back 11 C. CSF; synovial; pericardial fluid |
front 12 What is true? A) Total body fluid decreases with age B) Plasma volume doubles with age C) Intracellular fluid becomes extracellular D) Transcellular fluid progressively dominates | back 12 A. Total body fluid decreases with age |
front 13 Compared with men, women generally have lower total body water percentage. Which explanation and estimate are most accurate? A) Less fat B) More fat C) More muscle D) Less plasma | back 13 B. More fat |
front 14 A newborn has a higher total body water percentage than an adult woman. True or False. | back 14 true |
front 15 In a 70-kg adult with about 42 liters of total body water, approximately 28 liters are located where? A) Inside cells B) In plasma C) In interstitium D) In transcellular spaces | back 15 A. Inside cells 2/3rds inside cells, 1/3rds outside cells |
front 16 In the extracellular fluid, which compartment makes up more than three-fourths of the volume? A) Plasma B) Interstitial fluid C) Red cell fluid D) Cerebrospinal fluid | back 16 B. Interstitial fluid |
front 17 In the extracellular fluid, which compartment makes up almost one-fourth of the volume? A) Plasma B) Interstitial fluid C) Red cell fluid D) Cerebrospinal fluid | back 17 A) Plasma |
front 18 Which statement best describes plasma in relation to blood? A) Cellular portion of blood B) Noncellular portion of blood C) Fluid inside red cells D) Specialized transcellular fluid | back 18 B. Noncellular portion of blood |
front 19 Plasma exchanges substances continuously with interstitial fluid through which structure? A) Cell nuclear pores B) Renal collecting ducts C) Capillary membrane pores D) Alveolar epithelial cilia | back 19 C. Capillary membrane pores |
front 20 In a healthy adult, plasma and interstitial fluid—both components of the extracellular fluid—maintain a nearly identical electrolyte composition due to constant mixing. However, they differ significantly in their solute concentration because capillary membranes are relatively impermeable to large molecules. Which of the following represents the major difference between these two fluids? A) Higher protein concentration in the plasma | back 20 A) Higher protein concentration in the plasma While electrolytes and small solutes move freely between these two compartments, plasma proteins (like albumin) are generally too large to pass through the capillary walls. This results in a significantly higher concentration of proteins in the plasma compared to the interstitial fluid. This difference is critical because it creates the oncotic pressure (colloid osmotic pressure) necessary to pull water back into the blood vessels. |
front 21 When analyzing blood composition via hematocrit, it is observed that blood acts as a mini-ecosystem containing both major body fluid compartments. Based on the location of the fluid relative to the cell membranes of the formed elements, which of the following pairings correctly identifies these compartments? A) Plasma is Extracellular Fluid (ECF); Red cell fluid is
Intracellular Fluid (ICF) | back 21 A) Plasma is Extracellular Fluid (ECF); Red cell fluid is Intracellular Fluid (ICF) |
front 22 A normal blood sample is separated into its major components. Which distribution best matches typical blood composition? A) 40% plasma; 60% red cells B) 50% plasma; 50% red cells C) 60% plasma; 40% red cells D) 80% plasma; 20% red cells | back 22 C. 60% plasma; 40% red cells |
front 23 A centrifuged blood sample forms packed cells at the bottom of a hematocrit tube. Which interpretation of hematocrit is most accurate? A) Plasma protein concentration B) Red cell blood fraction C) Total extracellular volume D) Interstitial fluid fraction | back 23 B. Red cell blood fraction |
front 24 A patient has plasma and interstitial fluid with similar ionic compositions. Which anatomic feature best explains this similarity? A) Tight epithelial barriers B) Permeable capillary membranes C) Impermeable cell membranes D) Active neuronal transport | back 24 B. Permeable capillary membranes |
front 25 A physiology student asks why plasma holds slightly more sodium and potassium than interstitial fluid. Which property of plasma proteins best explains this? A) Positive net charge B) Negative net charge C) Complete membrane permeability D) High lipid solubility | back 25 B. Negative net charge This phenomenon is known as the Gibbs-Donnan Effect. Plasma proteins (like albumin) carry a net negative charge at physiological pH. Because these proteins are too large to leave the capillaries, they remain in the plasma and exert an electrical pull on positively charged ions (cations). |
front 26 Which organ system most directly maintains the carefully regulated composition of extracellular fluid? A) Kidneys B) Spleen C) Pancreas D) Adrenal cortex | back 26 A. Kidneys |
front 27 A sample of intracellular fluid is compared with extracellular fluid. Which electrolyte pattern best matches intracellular fluid? A) High sodium, high chloride B) High potassium, high phosphate C) High calcium, high chloride D) High sodium, high calcium | back 27 B. High potassium, high phosphate |
front 28 Which pair is normally present only in small quantities in intracellular fluid compared with extracellular fluid? A) Potassium and phosphate B) Sodium and chloride C) Magnesium and sulfate D) Protein and phosphate | back 28 B. Sodium and chloride |
front 29 Which ion is present at almost negligible concentration inside cells under normal conditions? A) Sodium B) Chloride C) Calcium D) Potassium | back 29 C. Calcium |
front 30 A cell’s intracellular fluid contains moderate amounts of two ions that are relatively low in extracellular fluid. Which pair is most accurate? A) Sodium and chloride B) Calcium and bicarbonate C) Magnesium and sulfate D) Albumin and sodium | back 30 C. Magnesium and sulfate |
front 31 A researcher measures a body fluid compartment by injecting a marker, allowing even distribution, then measuring dilution. What principle is being used? A) Indicator dilution B) Osmotic filtration C) Capillary exchange D) Donnan equilibrium | back 31 A. Indicator dilution |
front 32 In an indicator-dilution experiment, what two values are required to calculate compartment volume? A) Hematocrit and plasma proteins B) Total indicator and final concentration C) Urine output and sweat loss D) Sodium level and osmolality | back 32 B. Total indicator and final concentration |
front 33 A tracer is injected into a compartment and allowed to disperse completely. If the final concentration is lower, what does this imply about the compartment? A) Smaller volume B) Larger volume C) Lower permeability D) Higher hematocrit | back 33 B. Larger volume v = m/c |
front 34 A substance used to estimate extracellular fluid volume should distribute where? A) Plasma and interstitial fluid B) Plasma and red cells C) Intracellular fluid D) Transcellular fluid only | back 34 A. Plasma and interstitial fluid |
front 35 Which property is required for a marker used to estimate extracellular fluid volume? A) Crosses cell membranes rapidly B) Binds tightly to erythrocytes C) Avoids cell membrane permeation D) Remains only in plasma | back 35 C. Avoids cell membrane permeation |
front 36 Which set contains substances used to estimate extracellular fluid volume? A) Inulin, thiosulfate, iothalamate B) Albumin, Evans blue, chromium C) Antipyrine, tritium, deuterium D) Hemoglobin, albumin, sodium | back 36 A. Inulin, thiosulfate, iothalamate |
front 37 Which compartment cannot be measured directly using a standard indicator-dilution marker? A) Plasma volume B) Extracellular volume C) Intracellular volume D) Total body water | back 37 C. Intracellular volume |
front 38 A patient’s total body water and extracellular fluid volume are known. How should intracellular fluid volume be calculated? A) Plasma minus hematocrit B) TBW minus ECF volume C) ECF minus plasma volume D) Blood minus plasma volume | back 38 B. TBW minus ECF volume |
front 39 A marker for measuring plasma volume must have which distribution property after injection? A) Crosses capillaries freely B) Enters red cells rapidly C) Remains intravascular D) Permeates all cells | back 39 C. Remains intravascular |
front 40 Which labeled substance is commonly used to measure plasma volume? A) 125I-labeled serum albumin B) 51Cr-labeled red cells C) Tritiated water D) Radioactive chloride | back 40 A. 125I-labeled serum albumin |
front 41 Evans blue dye can measure plasma volume because it has which key property? A) Binds plasma proteins B) Crosses cell membranes C) Enters red blood cells D) Labels intracellular water | back 41 A. Binds plasma proteins |
front 42 A patient’s extracellular fluid volume and plasma volume are measured. Which calculation gives interstitial fluid volume? A) Plasma volume divided hematocrit B) ECF volume minus plasma volume C) TBW minus extracellular volume D) Blood volume minus red cells | back 42 B. ECF volume minus plasma volume |
front 43 A patient has a plasma volume of 3 L and hematocrit of 40%. What is the estimated total blood volume? A) 4 L B) 5 L C) 6 L D) 7 L | back 43 B. 5 L |
front 44 Which formula correctly calculates total blood volume from plasma volume and hematocrit? A) Plasma volume × hematocrit B) Plasma volume ÷ hematocrit C) Plasma volume × (1 − hematocrit) D) Plasma volume ÷ (1 − hematocrit) | back 44 D. Plasma volume ÷ (1 − hematocrit) |
front 45 An investigator wants to measure blood volume directly using labeled cells. Which approach is most appropriate? A) Inject labeled red blood cells B) Inject lipid-soluble antipyrine C) Inject Evans blue dye D) Inject radioactive chloride | back 45 A. Inject labeled red blood cells |
front 46 Which radioactive material is frequently used to label red blood cells for blood volume measurement? A) 125I B) 3H C) 51Cr D) 2H | back 46 C. 51Cr |
front 47 The distribution of water between intracellular and extracellular compartments is mainly governed by which force? A) Osmotic solute effects B) Plasma oncotic pressure only C) Red cell sedimentation D) Protein-bound dye movement | back 47 A. Osmotic solute effects |
front 48 Which solutes are especially important for osmotic water distribution across cell membranes? A) Sodium, chloride, electrolytes B) Albumin, globulin, fibrinogen C) Urea, creatinine, bilirubin D) Glucose, lactate, ketones | back 48 A. Sodium, chloride, electrolytes |
front 49 A cell membrane separates intracellular from extracellular fluid. What process describes water diffusion across this membrane? A) Filtration B) Osmosis C) Secretion D) Pinocytosis | back 49 B. Osmosis |
front 50 Which of the following pairings correctly identifies the denominator used for osmolality and osmolarity, respectively?" A) Per liter of water; per kilogram of solution B) Per liter of solution; per kilogram of water C) Per kilogram of water; per liter of solution D) Per kilogram of solution; per liter of plasma | back 50 C) Per kilogram of water; per liter of solution |
front 51 A red blood cell is placed in a solution and neither shrinks nor swells. Which description best matches this solution? A) Isotonic to the cell B) Hypotonic to the cell C) Hypertonic to the cell D) Hyperosmotic to plasma | back 51 A. Isotonic to the cell |
front 52 A red blood cell is placed in fluid containing fewer impermeant solutes than intracellular fluid. Which sequence is most likely? A) Water exits; cell shrinks B) Sodium exits; cell swells C) Water enters; cell shrinks D) Water enters; cell swells | back 52 D. Water enters; cell swells |
front 53 A cell placed in a hypotonic solution swells until osmotic equilibrium is reached. What happens to the extracellular fluid during this process? A) It becomes more dilute B) It becomes protein-free C) It becomes more concentrated D) It becomes completely isotonic | back 53 C. It becomes more concentrated |
front 54 A patient receives a hypertonic infusion containing excess impermeant solute. Which immediate cellular water shift is expected? A) Water enters cells B) Water leaves cells C) Sodium leaves plasma D) Chloride enters cells | back 54 B. Water leaves cells |
front 55 A physiology instructor explains why osmotic shifts after water intake occur quickly. Which membrane property is most responsible? A) Sodium crosses rapidly B) Water crosses rapidly C) Proteins cross rapidly D) Chloride crosses rapidly | back 55 B. Water crosses rapidly |
front 56 Cell membranes prevent many extracellular solutes from freely entering cells. Which solute pair is emphasized as largely impermeant across cell membranes? A) Urea and glucose B) Calcium and albumin C) Sodium and chloride D) Potassium and phosphate | back 56 C. Sodium and chloride |
front 57 Because many solutes cannot freely cross cell membranes, what generally remains constant within intracellular and extracellular compartments? A) Number of osmoles B) Total water content C) Plasma protein charge D) Capillary hydrostatic pressure | back 57 A. Number of osmoles |
front 58 A hospitalized patient receives a glucose-containing IV solution. How are such nutrient solutions usually administered to avoid osmotic disturbance? A) Always strongly hypertonic B) Always strongly hypotonic C) Only as lipid emulsions D) Isotonic or slowly infused | back 58 D. Isotonic or slowly infused |
front 59 Which IV nutrient solution is most widely used out of these options? A) Amino acid solutions B) Glucose solutions C) Homogenized fat solution D) Albumin solutions | back 59 B. Glucose solutions |
front 60 A clinician estimates plasma osmolarity without directly measuring it. Which serum value is usually the most useful surrogate? A) Sodium concentration B) Potassium concentration C) Albumin concentration D) Calcium concentration | back 60 A. Sodium concentration |
front 61 Why can plasma sodium concentration often approximate plasma osmolarity under many clinical conditions? A) Sodium freely enters cells B) Sodium binds albumin completely C) Sodium salts dominate ECF solute D) Sodium reflects intracellular proteins | back 61 C. Sodium salts dominate ECF solute |
front 62 Sodium and its associated anions account for approximately what fraction of extracellular fluid solute? A) About 25 percent B) About 50 percent C) About 75 percent D) More than 90 percent | back 62 D. More than 90 percent |
front 63 A patient develops a decreased plasma sodium concentration. Which two broad mechanisms can produce this finding? A) Sodium loss; excess water B) Potassium loss; protein gain C) Calcium gain; water loss D) Albumin loss; chloride gain | back 63 A. Sodium loss; excess water |
front 64 A patient loses sodium chloride primarily from the extracellular fluid. Which combined finding is most expected? A) Hypernatremia with overhydration B) Hyponatremia with dehydration C) Hypernatremia with dehydration D) Hyponatremia with edema | back 64 B. Hyponatremia with dehydration |
front 65 Primary sodium chloride loss usually causes hyponatremia associated with which extracellular fluid volume change? A) Increased ECF volume B) Normal ECF volume C) Decreased ECF volume D) Increased plasma volume | back 65 C. Decreased ECF volume |
front 66 A patient presents after several days of vomiting and diarrhea. Which electrolyte-volume pattern is most directly explained by these losses? A) Hypernatremia; overhydration B) Hyperkalemia; plasma expansion C) Hypocalcemia; intracellular swelling D) Hyponatremia; decreased ECF volume | back 66 D. Hyponatremia; decreased ECF volume |
front 67 A patient overuses a diuretic that blocks renal sodium conservation. Which disorder may develop as a result? A) Hypocalcemia B) Hypernatremia C) Hyponatremia D) Hyperphosphatemia | back 67 C. Hyponatremia |
front 68 A sodium-wasting kidney disease causes modest hyponatremia. What renal function is most directly impaired? A) Conserving sodium B) Excreting potassium C) Filtering proteins D) Producing aldosterone | back 68 A. Conserving sodium |
front 69 A patient with adrenal insufficiency has low aldosterone secretion. Which renal defect best explains the associated modest hyponatremia? A) Excess sodium reabsorption B) Impaired sodium reabsorption C) Excess water excretion D) Impaired potassium excretion | back 69 B. Impaired sodium reabsorption |
front 70 Which condition links decreased aldosterone secretion with impaired renal sodium reabsorption and modest hyponatremia? A) Cushing syndrome B) Conn syndrome C) SIADH D) Addison disease | back 70 D. Addison disease |
front 71 A euvolemic-appearing patient has low plasma sodium due primarily to retained water diluting extracellular sodium. Which term best describes this pattern? A) Hyponatremia-overhydration B) Hyponatremia-dehydration C) Hypernatremia-overhydration D) Hypernatremia-dehydration | back 71 A. Hyponatremia-overhydration |
front 72 A marathon runner rapidly develops severe hyponatremia after excessive water intake. Which brain complication explains headache, nausea, lethargy, and disorientation? A) Neuronal demyelination B) Brain cell edema C) Cerebral sodium retention D) Plasma protein leakage | back 72 B. Brain cell edema |
front 73 Why can rapid hyponatremia become fatal even before major systemic organ failure? A) Skull permits unlimited swelling B) Brain volume cannot expand much C) Sodium immediately enters neurons D) CSF instantly absorbs edema | back 73 B. Brain volume cannot expand much |
front 74 A patient with acute severe hyponatremia deteriorates as the swollen brain is forced downward through the skull base. What is this complication called? A) Osmotic demyelination B) Cerebral filtration C) Brain herniation D) Central pontine adaptation | back 74 C. Brain herniation |
front 75 A patient’s chronic hyponatremia is corrected too rapidly with hypertonic saline. What neuronal injury is classically associated with this management error? A) Brain cell edema B) Osmotic demyelination C) Intracellular acidosis D) Capillary rupture | back 75 B. Osmotic demyelination |
front 76 Why can overly rapid hypertonic correction of hyponatremia injure neurons? A) It outpaces solute recapture B) It blocks sodium excretion C) It increases brain edema D) It denudes capillary membranes | back 76 A. It outpaces solute recapture |
front 77 During adaptation to hyponatremia, brain cells lose solutes. Rapid hypertonic therapy becomes dangerous when it exceeds the brain’s ability to do what? A) Excrete potassium B) Restore plasma proteins C) Recapture lost solutes D) Produce more CSF | back 77 C. Recapture lost solutes |
front 78 A hospitalized patient develops confusion and is found to have low plasma sodium. Which statement best describes this electrolyte disorder in clinical practice? A) Most common electrolyte disorder B) Rare outpatient-only disorder C) Usually caused by hyperosmolarity D) Less common than hypernatremia | back 78 A. Most common electrolyte disorder |
front 79 A patient develops increased plasma sodium concentration with increased extracellular osmolarity. Which two mechanisms can produce this pattern? A) Sodium loss; water gain B) Water loss; sodium excess C) Protein loss; potassium gain D) Chloride loss; albumin excess | back 79 B. Water loss; sodium excess |
front 80 A trauma patient develops polyuria after pituitary injury. Labs show hypernatremia and dilute urine. Which mechanism best explains central diabetes insipidus? A) Excess aldosterone secretion B) Lack of antidiuretic hormone C) Excess renal sodium conservation D) Increased plasma protein leakage | back 80 B. Lack of antidiuretic hormone |
front 81 Compared with hyponatremia, which statement best describes hypernatremia? A) More common and milder B) More common in hospitals C) Equal frequency clinically D) Much less common clinically | back 81 D. Much less common clinically |
front 82 A patient develops hypernatremia after free water loss. Which paired physiologic response helps prevent further sodium elevation? A) Thirst; ADH secretion B) Hunger; aldosterone suppression C) Sweating; insulin release D) Diuresis; ADH suppression | back 82 A. Thirst; ADH secretion |
front 83 Hypernatremia stimulates intense thirst and ADH secretion. What is the shared protective effect of these responses? A) Increase intracellular sodium entry B) Limit extracellular sodium rise C) Increase plasma protein filtration D) Block capillary sodium movement | back 83 B. Limit extracellular sodium rise |
front 84 A patient with hypernatremia requires correction of extracellular hyperosmolarity. Which fluid approach is most appropriate? A) Hypertonic saline rapidly B) Albumin with diuretics C) Packed red blood cells D) Hypo-osmotic NaCl or dextrose | back 84 D. Hypo-osmotic NaCl or dextrose |
front 85 A patient has excess fluid accumulation within body tissues. Which term best describes this finding? A) Ascites B) Anasarca C) Edema D) Polyuria | back 85 C. Edema |
front 86 In most patients with clinically apparent edema, excess fluid accumulates primarily in which compartment? A) Extracellular fluid B) Intracellular fluid C) Red blood cells D) Plasma only | back 86 A. Extracellular fluid |
front 87 Which set contains the three major conditions especially prone to causing intracellular swelling? A) Hypernatremia; fever; alkalosis B) Hyponatremia; metabolic depression; malnutrition C) Hyperkalemia; hypoxia; proteinuria D) Hypertension; lymph blockage; cancer | back 87 B. Hyponatremia; metabolic depression; malnutrition |
front 88 A severely malnourished patient develops cellular swelling despite no major lymphatic obstruction. Which mechanism is a recognized cause of intracellular edema? A) Increased capillary pressure B) Increased plasma oncotic pressure C) Excess extracellular sodium D) Lack of adequate nutrition | back 88 D. Lack of adequate nutrition |
front 89 A tissue sample from an inflamed wound shows cellular swelling. Which process best explains inflammation-related intracellular edema? A) Reduced membrane sodium entry B) Lower capillary hydrostatic pressure C) Increased membrane permeability D) Increased lymphatic drainage | back 89 C. Increased membrane permeability |
front 90 Inflammation increases cell membrane permeability and allows sodium and other ions to enter cells. What water movement follows? A) Water osmoses into cells B) Water exits into plasma C) Water remains extracellular only D) Water enters lymphatics directly | back 90 A. Water osmoses into cells |
front 91 A patient has excess fluid accumulation specifically in the extracellular spaces. Which term best describes this pattern? A) Intracellular edema B) Cerebral edema C) Cytotoxic edema D) Extracellular fluid edema | back 91 D. Extracellular fluid edema |
front 92 Which pair represents the two broad mechanisms that cause extracellular edema A) Cell swelling; RBC hemolysis B) Capillary leakage; lymphatic failure C) ADH loss; thirst suppression D) Sodium entry; water exit | back 92 B. Capillary leakage; lymphatic failure |
front 93 Extracellular fluid edema can occur when plasma fluid abnormally crosses capillaries into which space? A) Intracellular space B) Red blood cells C) Interstitial space D) Transcellular vesicles | back 93 C. Interstitial space |
front 94 Failure of lymphatics to return interstitial fluid to the blood is commonly called what? A) Lymphedema B) Hypernatremia C) Nephrotic syndrome D) Hydrocele | back 94 A. Lymphedema |
front 95 A patient with chronic filarial infection develops massive leg swelling and thickened skin. Which paired complication is most characteristic? A) Ascites; pulmonary edema B) Lymphedema; elephantiasis C) Hyponatremia; brain edema D) Proteinuria; nephrotic syndrome | back 95 B. Lymphedema; elephantiasis |
front 96 A man with filarial lymphatic obstruction develops marked scrotal swelling. Which term best describes this finding? A) Varicocele B) Spermatocele C) Hydrocele D) Hematocele | back 96 C. Hydrocele |
front 97 A woman develops arm swelling after breast cancer surgery involving lymph node removal. Which mechanism best explains the edema? A) Increased ADH release B) Excess sodium ingestion C) Reduced plasma osmolarity D) Obstructed lymph return | back 97 D. Obstructed lymph return |
front 98 Which clinical setting can cause lymphedema by removing or obstructing lymphatic vessels? A) Cancer surgery B) Central diabetes insipidus C) Acute hypernatremia D) Excess dextrose infusion | back 98 A. Cancer surgery |
front 99 Which set correctly lists major mechanisms of extracellular edema? A) Low sodium; low ADH; thirst B) High potassium; low calcium; fever C) High capillary pressure; low proteins D) Low capillary pressure; high proteins | back 99 C. High capillary pressure; low proteins |
front 100 Which abnormality lowers plasma colloid osmotic pressure and promotes generalized extracellular edema? A) Increased red cell volume B) Increased sodium concentration C) Reduced plasma protein level D) Reduced capillary permeability | back 100 C. Reduced plasma protein level |
front 101 A patient with severe liver disease cannot produce normal plasma proteins. Which sequence best explains the resulting edema? A) Protein fall; filtration decreases B) Protein fall; filtration increases C) Protein rise; filtration increases D) Protein rise; filtration decreases | back 101 B. Protein fall; filtration increases |
front 102 A patient loses large amounts of albumin from the bloodstream. What happens to plasma colloid osmotic pressure and capillary filtration? A) Osmotic pressure rises; filtration falls B) Osmotic pressure rises; filtration rises C) Osmotic pressure falls; filtration rises D) Osmotic pressure falls; filtration falls | back 102 C. Osmotic pressure falls; filtration rises |
front 103 Loss or underproduction of plasma proteins causes edema primarily in which fluid compartment? A) Intracellular fluid B) Cerebrospinal fluid C) Red blood cells D) Extracellular fluid | back 103 D. Extracellular fluid |
front 104 A patient has edema due to very low plasma protein concentration from urinary protein loss. Which diagnosis best matches this mechanism? A) Central diabetes insipidus B) Addison disease C) Nephrotic syndrome D) Filarial hydrocele | back 104 C. Nephrotic syndrome |
front 105 In nephrotic syndrome, which sequence best explains generalized edema? A) Proteinuria; low oncotic pressure B) Polyuria; high oncotic pressure C) Hematuria; high capillary resistance D) Glycosuria; low lymphatic flow | back 105 A. Proteinuria; low oncotic pressure |
front 106 A patient with cirrhosis develops generalized edema with low plasma oncotic pressure. Which liver change most directly reduces plasma protein concentration A) Portal vein dilation B) Fibrous tissue replacement C) Increased bile secretion D) Increased albumin filtration | back 106 B. Fibrous tissue replacement |
front 107 Cirrhosis is defined histologically by which structural change in the liver? A) Diffuse hepatocyte hypertrophy B) Large fibrous tissue deposition C) Isolated portal vein dilation D) Increased sinusoidal fenestration | back 107 B. Large fibrous tissue deposition |
front 108 A cirrhotic patient develops edema because plasma protein concentration falls. Which sequence best explains this mechanism? A) Fibrosis; protein reduction; edema B) Portal dilation; protein rise; edema C) Bile obstruction; sodium loss; edema D) Hepatocyte swelling; water loss; edema | back 108 A. Fibrosis; protein reduction; edema |
front 109 A cirrhotic patient develops ascites despite no nephrotic-range proteinuria. Which additional liver mechanism can promote abdominal fluid accumulation? A) Fibrosis compresses portal drainage B) Fibrosis dilates systemic arteries C) Fibrosis increases renal filtration D) Fibrosis blocks thoracic lymph | back 109 A) Fibrosis compresses portal drainage |
front 110 In cirrhosis, liver fibrosis may compress venous drainage vessels before they empty into general circulation. Which vascular bed is most involved? A) Pulmonary venous drainage B) Coronary venous drainage C) Portal venous drainage D) Cerebral venous drainage | back 110 C. Portal venous drainage |
front 111 A patient with cirrhosis has high portal capillary pressure and progressive abdominal distention. Which fluid movement best explains the ascites? A) Plasma enters red blood cells B) Fluid transudates into abdomen C) CSF enters peritoneal cavity D) Lymph drains into hepatocytes | back 111 B. Fluid transudates into abdomen |
front 112 High portal capillary pressures in cirrhosis can cause transudation of which substances into the abdominal cavity? A) Water only B) Red cells only C) Fluid and protein D) Bile and glucose | back 112 C. Fluid and protein |
front 113 A patient with portal hypertension develops a large volume of free abdominal fluid. Which term best describes this finding? A) Hydrocele B) Effusion C) Ascites D) Lymphedema | back 113 C. Ascites |
front 114 Which set correctly lists the three major safety factors that limit excessive interstitial fluid accumulation? A) High compliance; low lymph; protein retention B) Low compliance; lymph increase; washdown C) High proteins; lymph blockage; filtration D) Low sodium; ADH release; thirst | back 114 B. Low compliance; lymph increase; washdown |
front 115 When interstitial fluid pressure is negative, what property helps resist excessive edema formation? A) High interstitial compliance B) Low interstitial compliance C) Increased plasma permeability D) Increased intracellular swelling | back 115 B. Low interstitial compliance |
front 116 A patient begins developing increased capillary filtration, but interstitial swelling remains limited at first. Which lymphatic response helps buffer edema formation? A) Lymph flow stops completely B) Lymph flow increases markedly C) Lymph protein concentration rises D) Lymphatic vessels constrict permanently | back 116 B. Lymph flow increases markedly |
front 117 During increased capillary filtration, interstitial protein concentration decreases, lowering interstitial oncotic pressure. What is this protective mechanism called? A) Donnan equilibrium B) Protein washdown C) Portal transudation D) Capillary recruitment | back 117 B. Protein washdown |
front 118 How does washdown of interstitial proteins help prevent edema? A) Raises interstitial oncotic pressure B) Lowers interstitial oncotic pressure C) Raises plasma hydrostatic pressure D) Lowers plasma protein synthesis | back 118 B. Lowers interstitial oncotic pressure |
front 119 A patient has dependent swelling in which thumb pressure leaves a persistent indentation. Which fluid property best explains this finding? A) Free movement through tissues B) Fibrin clotting in interstitium C) Isolated cellular swelling D) Fluid trapped inside cells | back 119 A. Free movement through tissues |
front 120 A clinician presses a thumb into a swollen ankle and displaces interstitial fluid away from the pressed area. Which edema type is present? A) Nonpitting edema B) Pitting edema C) Intracellular edema D) Pulmonary edema | back 120 B. Pitting edema |
front 121 Pitting edema occurs because pressure on tissue can push fluid in which direction? A) Into red blood cells B) Into hepatocytes C) Out of the pressed area D) Through intact skull | back 121 C. Out of the pressed area |
front 122 A patient has swollen tissue that does not pit with thumb pressure because the tissue cells themselves are swollen. Which edema type is most consistent? A) Pitting edema B) Nonpitting edema C) Ascites D) Hydrocele | back 122 B. Nonpitting edema |
front 123 A patient has nonpitting edema because interstitial fluid is clotted and cannot move freely. Which protein is most responsible for this immobility? A) Albumin B) Globulin C) Fibrinogen D) Hemoglobin | back 123 C. Fibrinogen |
front 124 Which pair of mechanisms can produce nonpitting edema? A) Cell swelling; fibrinogen clotting B) Portal pressure; albumin loss C) Lymph increase; protein washdown D) Low compliance; high lymph | back 124 A. Cell swelling; fibrinogen clotting |
front 125 A patient with inflamed tissue has firm swelling that does not indent easily because interstitial fluid cannot move freely. Which description best matches this? A) Pitting edema from free flow B) Nonpitting edema from clotting C) Ascites from portal pressure D) Effusion from potential space | back 125 B. Nonpitting edema from clotting |
front 126 A patient has edema in subcutaneous tissues next to a potential space, and fluid also accumulates in that space. What is the collected fluid called? A) Ascites B) Effusion C) Hematocrit D) Washdown | back 126 B. Effusion |
front 127 When edema develops near a potential space, what usually happens to that adjacent space? A) It accumulates edema fluid B) It loses all protein C) It becomes intracellular fluid D) It blocks capillary pores | back 127 A. It accumulates edema fluid |
front 128 Which statement best distinguishes ascites from a general effusion? A) Ascites is abdominal cavity fluid B) Ascites is intracellular fluid C) Effusion is red cell fraction D) Effusion requires portal hypertension | back 128 A. Ascites is abdominal cavity fluid |