(M) CC2 Lec L1

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C

What is the definition of electrolytes?

• a. Uncharged particles in the intracellular fluid

• b. Molecules that only carry a positive charge

• c. Ions capable of carrying an electric charge

• d. Proteins that regulate plasma osmolality

• e. Enzymes that catalyze cellular shifts

B

How are cations classified in terms of their charge?

• a. Negatively charged ions

• b. Positively charged ions

• c. Neutral atoms

• d. Lipid-bound proteins

• e. Uncharged molecules

D

How are anions classified in terms of their charge?

• a. Positively charged ions

• b. Neutral atoms

• c. Covalent bonds

• d. Negatively charged ions

• e. Metallic isotopes

C

What is the primary extracellular fluid (ECF) cation?

• a. Potassium

• b. Magnesium

• c. Sodium

• d. Calcium

• e. Chloride

B

What is the primary intracellular fluid (ICF) cation?

• a. Sodium

• b. Potassium

• c. Bicarbonate

• d. Phosphate

• e. Chloride

E

What is the primary extracellular fluid (ECF) anion?

• a. Bicarbonate

• b. Sulfate

• c. Phosphate

• d. Sodium

• e. Chloride

D

Sodium represents approximately what percentage of all extracellular cations?

• a. 50%

• b. 60%

• c. 75%

• d. 90%

• e. 99%

B

Which of the following is the primary determinant of plasma osmolality?

• a. Glucose

• b. Sodium

• c. Urea

• d. Potassium

• e. Chloride

D

What is the normal reference range for Serum/Plasma Sodium?

• a. 3.5 - 5.1 mmol/L

• b. 98 - 107 mmol/L

• c. 120 - 160 mmol/L

• d. 135 - 145 mmol/L

• e. 8.5 - 10.5 mg/dL

B

What are the threshold critical values for Sodium?

• a. <135 or >145 mmol/L

• b. <120 or >160 mmol/L

• c. <3.0 or >6.0 mmol/L

• d. <98 or >107 mmol/L

• e. <110 or >150 mmol/L

C

Which hormone is secreted by the posterior pituitary and increases water reabsorption in the collecting ducts, diluting plasma Na+?

• a. Aldosterone

• b. Atrial Natriuretic Peptide

• c. Anti-Diuretic Hormone (Vasopressin)

• d. Renin

• e. Angiotensin II

D

Which hormone is secreted by the heart atria in response to volume expansion to promote sodium excretion?

• a. Aldosterone

• b. Anti-Diuretic Hormone

• c. Cortisol

• d. Atrial Natriuretic Peptide (ANP)

• e. Angiotensinogen

B

What is the primary function of Aldosterone regarding electrolytes?

• a. Promotes Na+ excretion in exchange for K+ reabsorption

• b. Promotes Na+ reabsorption in the distal tubules in exchange for K+ or H+ excretion

• c. Dilutes plasma Na+ by reabsorbing free water

• d. Promotes Cl- excretion in the collecting ducts

• e. Shifts K+ from the ECF into the ICF

C

Which condition is a primary cause of depletional (loss) hyponatremia?

• a. SIADH

• b. Nephrotic syndrome

• c. Addison's disease

• d. Congestive heart failure

• e. Cushing's syndrome

A

Which of the following is a classic cause of dilutional (water excess) hyponatremia?

• a. SIADH

• b. Severe burns

• c. Prolonged vomiting

• d. Diuretics

• e. Diabetes insipidus

D

Which of the following causes hypernatremia primarily through water loss?

• a. Hyperaldosteronism

• b. Cushing's syndrome

• c. Excessive IV saline

• d. Diabetes insipidus

• e. Congestive heart failure

E

Severe hyponatremia (below 125 mmol/L) causes severe neuropsychiatric symptoms primarily due to:

• a. Cardiac arrest

• b. Pulmonary edema

• c. Renal failure

• d. Muscle paralysis

• e. Cerebral edema

C

What pre-analytical artifact must be ruled out when a patient has hyperlipidemia or hyperproteinemia and is tested using indirect ISE?

• a. Pseudohypernatremia

• b. Pseudohyperkalemia

• c. Pseudohyponatremia

• d. True hyponatremia

• e. True hypernatremia

B

Which diagnostic methodology uses an un-diluted sample and is unaffected by lipids/proteins?

• a. Indirect ISE

• b. Direct ISE

• c. Flame Emission Photometry

• d. Coulometric-Amperometric Titration

• e. Spectrophotometry

D

What type of membrane is used in the Ion-Selective Electrode (ISE) for measuring Sodium?

• a. Valinomycin membrane

• b. Solid-state membrane

• c. Silver chloride membrane

• d. Glass ion-exchange membrane

• e. Mercuric thiocyanate membrane

C

In Flame Emission Photometry (FEP), what color flame does Sodium emit?

• a. Violet

• b. Red

• c. Yellow

• d. Green

• e. Blue

D

Why does hemolysis NOT significantly alter Sodium levels?

• a. Sodium is rapidly metabolized by ruptured cells

• b. Sodium is tightly bound to RBC proteins

• c. Hemoglobin neutralizes the sodium ions

• d. Sodium is primarily an extracellular cation

• e. The ISE method automatically corrects for hemolyzed RBCs

A

What percentage of the body's potassium is located in the extracellular fluid (ECF)?

• a. 2%

• b. 10%

• c. 50%

• d. 90%

• e. 98%

C

What is the normal reference range for Serum Potassium?

• a. 135 - 145 mmol/L

• b. 98 - 107 mmol/L

• c. 3.5 - 5.1 mmol/L

• d. 8.5 - 10.5 mg/dL

• e. 1.5 - 2.5 mEq/L

C

What are the threshold critical values for Potassium?

• a. <120 or >160 mmol/L

• b. <98 or >107 mmol/L

• c. <3.0 or >6.0 mmol/L

• d. <1.0 or >10.0 mmol/L

• e. <3.5 or >5.1 mmol/L

B

Which acid-base imbalance pushes Potassium into the cells, potentially causing hypokalemia?

• a. Acidosis

• b. Alkalosis

• c. Hypercapnia

• d. Hypoxia

• e. Ketoacidosis

C

Which condition pulls Potassium out of the cells into the extracellular fluid?

• a. Alkalosis

• b. Insulin administration

• c. Acidosis

• d. Catecholamine release

• e. High atrial natriuretic peptide

D

Which condition is a primary cause of hypokalemia due to renal loss?

• a. Diarrhea

• b. Vomiting

• c. Addison's disease

• d. Hyperaldosteronism

• e. Renal failure

D

What is the classic ECG change associated with Hypokalemia?

• a. Peaked T waves

• b. Widened QRS complex

• c. ST segment elevation

• d. Flattened T waves and prominent U waves

• e. Absent P waves

C

What is the classic ECG change associated with Hyperkalemia?

• a. Flattened T waves

• b. Prominent U waves

• c. Peaked T waves

• d. Prolonged PR interval only

• e. Inverted P waves

B

A classic board scenario describes pouring a lavender top tube into a chemistry tube. What is the expected result?

• a. Massive spike in Na+, near-zero Cl-

• b. Massive spike in K+, near-zero Calcium

• c. Massive spike in Ca2+, near-zero K+

• d. Falsely decreased K+, elevated Na+

• e. Falsely elevated glucose and decreased K+

D

Prolonged tourniquet use or excessive fist clenching during blood extraction causes which pre-analytical error?

• a. Falsely decreased Sodium

• b. Falsely elevated Chloride

• c. Falsely decreased Potassium

• d. Falsely elevated Potassium

• e. Falsely decreased Chloride

C

What specific membrane is used in the Ion-Selective Electrode (ISE) for measuring Potassium?

• a. Glass ion-exchange membrane

• b. Solid-state membrane

• c. Valinomycin membrane

• d. Silver chloride membrane

• e. Pilocarpine membrane

A

In Flame Emission Photometry (FEP), what color flame does Potassium emit?

• a. Violet

• b. Red

• c. Yellow

• d. Green

• e. Orange

D

What is the normal reference range for Serum/Plasma Chloride?

• a. 135 - 145 mmol/L

• b. 3.5 - 5.1 mmol/L

• c. 120 - 160 mmol/L

• d. 98 - 107 mmol/L

• e. >60 mmol/L

B

What is the "Hamburger Phenomenon"?

• a. The process of Na+ reabsorption in exchange for K+

• b. The Chloride Shift where Cl- enters the RBC when HCO3- leaves to maintain electrical neutrality

• c. The mechanism of pseudohyponatremia due to lipid displacement

• d. The generation of silver ions to titrate Cl-

• e. The shifting of K+ into cells during alkalosis

A

Prolonged vomiting results in the loss of stomach acid (HCl). How does the body compensate, and what is the resulting acid-base disorder?

• a. The body retains HCO3-, leading to metabolic alkalosis

• b. The body retains HCO3-, leading to metabolic acidosis

• c. The body excretes HCO3-, leading to metabolic acidosis

• d. The body excretes HCO3-, leading to respiratory alkalosis

• e. The body retains Cl-, leading to metabolic alkalosis

C

Prolonged diarrhea leads to the loss of HCO3-. How does this affect Chloride, and what is the resulting condition?

• a. Cl- is lost, causing hypochloremic metabolic alkalosis

• b. Cl- is lost, causing hyperchloremic respiratory acidosis

• c. Cl- is retained to maintain neutrality, causing hyperchloremic metabolic acidosis

• d. Cl- is retained to maintain neutrality, causing hypochloremic metabolic acidosis

• e. Cl- remains unchanged, causing respiratory alkalosis

C

What type of membrane is used in the Ion-Selective Electrode (ISE) for Chloride?

• a. Glass ion-exchange membrane

• b. Valinomycin membrane

• c. Solid-state membrane (often AgCl/AgS)

• d. Lipid bilayer membrane

• e. Silicone membrane

D

Which methodology for Chloride diagnostics uses the principle of generating silver ions that combine with Cl- to form AgCl?

• a. ISE solid-state membrane

• b. Spectrophotometric / Colorimetric

• c. Flame Emission Photometry

• d. Coulometric-Amperometric Titration (Cotlove)

• e. Gibson-Cooke Pilocarpine Iontophoresis

A

In the Spectrophotometric/Colorimetric method for testing Chloride, which reagent forms a reddish complex?

• a. Mercuric thiocyanate

• b. Silver sulfide

• c. Silver chloride

• d. Valinomycin

• e. Ferric hexacyanoferrate

E

In the Gibson-Cooke Pilocarpine Iontophoresis (Sweat Test), a sweat chloride level >60 mmol/L is the definitive diagnostic test for which condition?

• a. Congestive heart failure

• b. Diabetes insipidus

• c. Addison's disease

• d. Conn's syndrome

• e. Cystic Fibrosis