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 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 21 C. 60% plasma; 40% red cells |
front 22 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 22 B. Red cell blood fraction |
front 23 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 23 B. Permeable capillary membranes |
front 24 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 24 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 25 Which organ system most directly maintains the carefully regulated composition of extracellular fluid? A) Kidneys B) Spleen C) Pancreas D) Adrenal cortex | back 25 A. Kidneys |
front 26 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 26 B. High potassium, high phosphate |
front 27 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 27 B. Sodium and chloride |
front 28 Which ion is present at almost negligible concentration inside cells under normal conditions? A) Sodium B) Chloride C) Calcium D) Potassium | back 28 C. Calcium |
front 29 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 29 C. Magnesium and sulfate |
front 30 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 30 A. Indicator dilution |
front 31 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 31 B. Total indicator and final concentration |
front 32 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 32 B. Larger volume v = m/c |
front 33 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 33 A. Plasma and interstitial fluid |
front 34 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 34 C. Avoids cell membrane permeation |
front 35 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 35 A. Inulin, thiosulfate, iothalamate |
front 36 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 36 C. Intracellular volume |
front 37 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 37 B. TBW minus ECF volume |
front 38 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 38 C. Remains intravascular |
front 39 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 39 A. 125I-labeled serum albumin |
front 40 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 40 A. Binds plasma proteins |
front 41 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 41 B. ECF volume minus plasma volume |
front 42 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 42 B. 5 L |
front 43 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 43 D. Plasma volume ÷ (1 − hematocrit) |
front 44 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 44 A. Inject labeled red blood cells |
front 45 Which radioactive material is frequently used to label red blood cells for blood volume measurement? A) 125I B) 3H C) 51Cr D) 2H | back 45 C. 51Cr |
front 46 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 46 A. Osmotic solute effects |
front 47 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 47 A. Sodium, chloride, electrolytes |
front 48 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 48 B. Osmosis |
front 49 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 49 A. Isotonic to the cell |
front 50 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 50 D. Water enters; cell swells |
front 51 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 51 C. It becomes more concentrated |
front 52 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 52 B. Water leaves cells |
front 53 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 53 B. Water crosses rapidly |
front 54 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 54 C. Sodium and chloride |
front 55 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 55 A. Number of osmoles |
front 56 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 56 D. Isotonic or slowly infused |
front 57 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 57 B. Glucose solutions |
front 58 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 58 A. Sodium concentration |
front 59 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 59 C. Sodium salts dominate ECF solute |
front 60 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 60 D. More than 90 percent |
front 61 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 61 A. Sodium loss; excess water |
front 62 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 62 B. Hyponatremia with dehydration |
front 63 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 63 C. Decreased ECF volume NaCl loss → water leaves/is lost from ECF → ↓ extracellular fluid volume → hyponatremia |
front 64 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 64 D. Hyponatremia; decreased ECF volume |
front 65 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 65 C. Hyponatremia |
front 66 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 66 A. Conserving sodium |
front 67 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 67 B. Impaired sodium reabsorption |
front 68 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 68 D. Addison disease |
front 69 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 69 A. Hyponatremia-overhydration |
front 70 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 70 B. Brain cell edema |
front 71 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 71 B. Brain volume cannot expand much |
front 72 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 72 C. Brain herniation |
front 73 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 73 B. Osmotic demyelination |
front 74 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 74 A. It outpaces solute recapture |
front 75 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 75 C. Recapture lost solutes |
front 76 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 76 A. Most common electrolyte disorder |
front 77 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 77 B. Lack of antidiuretic hormone |
front 78 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 78 D. Much less common clinically |
front 79 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 79 A. Thirst; ADH secretion |
front 80 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 80 B. Limit extracellular sodium rise |
front 81 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 81 D. Hypo-osmotic NaCl or dextrose |
front 82 A patient has excess fluid accumulation within body tissues. Which term best describes this finding? A) Ascites B) Anasarca C) Edema D) Polyuria | back 82 C. Edema |
front 83 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 83 A. Extracellular fluid |
front 84 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 84 B. Hyponatremia; metabolic depression; malnutrition |
front 85 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 85 D. Lack of adequate nutrition |
front 86 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 86 C. Increased membrane permeability |
front 87 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 87 A. Water osmoses into cells |
front 88 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 88 D. Extracellular fluid edema |
front 89 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 89 B. Capillary leakage; lymphatic failure |
front 90 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 90 C. Interstitial space |
front 91 Failure of lymphatics to return interstitial fluid to the blood is commonly called what? A) Lymphedema B) Hypernatremia C) Nephrotic syndrome D) Hydrocele | back 91 A. Lymphedema |
front 92 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 92 B. Lymphedema; elephantiasis |
front 93 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 93 C. Hydrocele |
front 94 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 94 D. Obstructed lymph return |
front 95 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 95 A. Cancer surgery |
front 96 Which set correctly lists major mechanisms that cause extracellular/interstitial edema? A) Low sodium and low ADH | back 96 C) High capillary hydrostatic pressure and low plasma protein |
front 97 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 97 C. Reduced plasma protein level |
front 98 A patient with severe liver disease cannot produce normal plasma proteins. Which sequence best explains the resulting edema? (filtration means leakage from the capillaries into surrounding tissues) A) Protein fall; filtration decreases B) Protein fall; filtration increases C) Protein rise; filtration increases D) Protein rise; filtration decreases | back 98 B. Protein fall; filtration increases |
front 99 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 99 C. Osmotic pressure falls; filtration rises |
front 100 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 100 D. Extracellular fluid |
front 101 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 101 C. Nephrotic syndrome |
front 102 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 102 A. Proteinuria; low oncotic pressure |
front 103 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 103 B. Fibrous tissue replacement |
front 104 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 104 B. Large fibrous tissue deposition |
front 105 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 105 A. Fibrosis; protein reduction; edema |
front 106 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 106 A) Fibrosis compresses portal drainage |
front 107 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 107 C. Portal venous drainage |
front 108 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 108 B. Fluid transudates into abdomen |
front 109 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 109 C. Fluid and protein |
front 110 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 110 C. Ascites |
front 111 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 111 B. Low compliance; lymph increase; washdown |
front 112 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 112 B. Low interstitial compliance |
front 113 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 113 B. Lymph flow increases markedly |
front 114 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 114 B. Protein washdown |
front 115 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 115 B. Lowers interstitial oncotic pressure |
front 116 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 116 A. Free movement through tissues |
front 117 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 117 B. Pitting edema |
front 118 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 118 C. Out of the pressed area |
front 119 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 119 B. Nonpitting edema |
front 120 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 120 C. Fibrinogen |
front 121 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 121 A. Cell swelling; fibrinogen clotting |
front 122 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 122 B. Nonpitting edema from clotting |
front 123 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 123 B. Effusion |
front 124 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 124 A. It accumulates edema fluid |