Topic 15. Pathophysiology of acid-base balance and phosphate-calcium metabolism.

1. At examination of patient following were found: hyperglycemia, ketonuria, polyuria, hyperstenuria, and glucosuria. What kind of acid-base balance disturbances occurs in this case?

A. Gas alkalosis

B. Non-gas alkalosis

C. Metabolic alkalosis

D. Metabolic acidosis

E. Gas alkalosis

2. Acidosis develops in case of severe form of diabetes mellitus. What buffer system components change at first?

A. Bicarbonate

B. Phosphate

C. Hemoglobin

D. Oxihemoglobin

E. Protein

3. Prolonged convulsions occur in patient suffered from epilepsy. After that following data of laboratory analysis of this patient were received: pH – 7.14, pCO₂ – 45 mmHg, HCO₃^- – 14 mmol/l, Na⁺ - 140 mmol/l, Cl^- - 98 mmol/l. What kind of acid-base balance disturbances occurs in this patient?

A. Metabolic ketoacidosis

B. Metabolic lactoacidosis

C. Respiratory alkalosis

D. Metabolic alkalosis

E. There are no disorders of acid-base balance

4. While ascending to mountain in alpinist excitation developed that was replaced with headache, giddiness, breathlessness, and after that apnea occurred. What kind of acid-base balance disturbances occurs in this case?

A. Non-gas acidosis

B. Excretory acidosis

C. Gas alkalosis

D. Non-gas alkalosis

E. Gas acidosis

5. A patient suffered from chronic glomerulonephritis has increasing general malaise, tachycardia with recurrent arrhythmia, confusion, and sleepiness. What kind of acid-base balance disturbance accompanies uremic coma?

A.Non-gas excretory acidosis

B. Non-gas excretory alkalosis

C. Gas acidosis

D. Gas alkalosis

E. Respiratory alkalosis

6. Pregnant woman has toxicosis accompanied by vomiting of 24 hours duration. After that tetany cramps and dehydration develop. What kind of shift of acid-base balance leads to described changes?

A. Gas alkalosis

B. Gas acidosis

C. Non-gas metabolic acidosis

D. Non-gas metabolic alkalosis

E.Non-gas excretory alkalosis

7.A patient suffered from diabetes mellitus was admitted to the hospital because of worsening of his condition. He has general malaise, polyuria, lethargy, and sleepiness. Kussmaul respiration, heart arrhythmia, and acetone scent in expired air are noticed in this patient. What kind of shift of acid-base balance contributes these symptoms?

A. Gas alkalosis

B. Gas acidosis

C. Non-gas metabolic alkalosis

D. Non-gas metabolic acidosis

E. Non-gas excretory alkalosis

8. A group of alpinists was undergone blood analysis in mountains at height 3000 meters. Following was revealed: decrease of HCO₃^- down to 15 mmol/l (norm is 22-26 mmol/l). What is the mechanism of decrease of HCO₃^- in the blood?

A. Decrease of reabsorption of bicarbonate in kidneys

B. Hyperventilation

C. Intensification of acidogenesis

D. Hypoventilation

E. Reduction of ammoniogenesis

9. pH of blood of patient suffered from diabetes mellitus sets to 7.3. What component of buffer system determination is used to diagnose disorders of acid-base balance?

A. Bicarbonate

B. Oxihemoglobin

C. Phosphate

D. Hemoglobin

E. Protein

10. Buffer capacity of blood decreases in worker as a result of exhausting muscle work. What acid substance income to the blood this may be explained?

A. Alpha-ketoglutaric acid

B. 3-phosphoglycerate

C. Lactic acid

D. Pyruvate

E. 1,3-biphosphoglycerate

11. Repeated vomiting occurs in patient suffered from pylorostenosis which is accompanied by loss of chloride ions from the organism and development of non-gas alkalosis. What conditions these changes of acid-base balance may result from?

A. Hyperchloridemia

B. Hyponatremia

C. Hypokalemia

D. Hypernatremia

E. Hyperhposphatemia

12. 48-years-old patient with diabetes mellitus was admitted to the hospital in severe pre-coma state. When examining of acid-base balance metabolic acidosis was revealed. Patient was treated with complex therapy including insulin intramuscular injections and sodium bicarbonate solution intravenous infusion. What is the main possible mechanism of found changes development?

A. Disorders of O₂ using in cells

B. Disorders of buffer systems of blood

C. Decrease of CO₂ removing

D. Excretion of alkali elements with urine

E. Formation of products of incomplete oxidation

13. Patient has disturbances of airways passage at the level of small and medium bronchi. What kind of acid-base disorders may develop in this patient?

A. Respiratory alkalosis

B. Metabolic alkalosis

C. Respiratory acidosis

D. Metabolic acidosis

E. Acid-base balance does not change

14. In patient suffered from diabetes mellitus coma has developed due to disorders of acid-base balance. What kind of acid-base disorders develops in this case?

A. Exogenous acidosis

B. Respiratory acidosis

C. Metabolic acidosis

D. Gas alkalosis

E. Non-gas alkalosis

15. A woman has distinct hypersalivation syndrome. Patient has to remove saliva from her mouth with napkin because of hard pain when she is swallowing. What kind of acid-base disorders may develop in this patient in some time?

A. Non-gas excretory acidosis

B. Gas alkalosis

C. Metabolic acidosis

D. Non-gas excretory alkalosis

E. Gas acidosis

16. During bronchial asthma attack patient developed gas acidosis (hypercapnia). What buffer system of blood plays the main role in compensation of this condition?

A. Bicarbonate

B. Hemoglobin

C. Phosphate

D. Protein

E. Ammoniogenesis

17. At examination of a patient hyperglycemia, ketonuria, polyuria, hyperstenuria, and glucosuria were revealed. What type of acid-base balance disorder takes place in this case?

A. Metabolic acidosis

B. Gas acidosis

C. Metabolic alkalosis

D. Non-gas alkalosis

E. Gas alkalosis

18. A 65-years-old patient with multiple fractures of ribs was admitted to the hospital. What type of acid-base balance disorder may develop in him?

A. Gas acidosis

B. Gas alkalosis

C. Non-gas acidosis

D. Non-gas alkalosis

E. There are no disorders of acid-base balance

19. A pregnant woman has toxicosis, which accompanied by prolonged vomiting. Data of her biochemical analyses show: pH of blood – 7.38, pCO₂ of arterial blood – 46 mmHg, SB – 17 mmol/L, BE – (+ 6 mmol/L). What type of acid-base balance disorder takes place in this case?

A. Compensated non-gas alkalosis

B. Decompensated non-gas alkalosis

C. Compensated non-gas acidosis

D. Decompensated non-gas acidosis

E. Compensated gas alkalosis

20. A 58-years-old female patient was admitted to the hospital in severe state. Data of her biochemical analyses show: pH of blood – 7.33, pCO₂ of arterial blood – 36 mmHg, SB – 17 mmol/L, BE – (+ 6 mmol/L). What type of acid-base balance disorder takes place in this case?

A. Compensated non-gas alkalosis

B. Decompensated non-gas alkalosis

C. Compensated non-gas acidosis

D. Decompensated non-gas acidosis

E. Compensated gas alkalosis

21. What is the reason for gas alkalosis?

A. Pulmonary hyperventilation

B. Loss of gastric juice

C. Loss of intestine juice

D. Pulmonary hypoventilation

E. Hyperaldosteronism

22. What kind of acid-base balance disturbances may be observed in case of diabetes mellitus?

A. Non-gas acidosis

B. Gas acidosis

C. Gas alkalosis

D. Non-gas alkalosis

E. Excretory acidosis

ANSWERS:

1.-D. 2.-A. 3.-B. 4.-E. 5.-A. 6.-E. 7.-D. 8.-B. 9.-A. 10.-C. 11.-C. 12.-E. 13.-C. 14.-C. 15.-A. 16.-B. 17.-A. 18.-A. 19.-A. 20.-B. 21.-A. 22.-A.

Дата добавления: 2015-07-25