🥵 HARD

I’m labelling FEB questions as hard because I really think they can mess with you.  It took me a very long time to get around to writing these, and to thinking about it.  But, sadly, whether med or surgery is your call … you need to know about Na, K and Ca derangements.  This quiz in particular covers sodium changes.  Good luck! 

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FEB - Part One

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Question 1
What is the threshold for hypernatraemia?
A
Serum Na+ >145mmol/L
B
Serum Na+ >135mmol/L
C
Serum Na+ >125mmol/L
D
Urine Na+ >145mmol/L
E
Urine Na+ >135mmol/L
Question 2
Which conditions can be ascertained by measuring urine osmolality?
A
Cushing's syndrome
B
Conn's Syndrome
C
Nephrogenic DI
D
Central DI
E
Excessive IV Na therapy
Question 3
High urine osmolality is correlated to which of the following diagnoses?
A
Stroke
B
Nephrogenic DI
C
Vomiting
D
Hypertonic saline
E
Diarrhoea
Question 4
Which figure correlates to the serum threshold of hyponatraemia?
A
<145mmol/L
B
<125mmol/L
C
<135mmol/L
D
<115mmol/L
E
<105mmol/L
Question 5
What is the most important concern when correcting hyponatraemia?
A
Cerebral oedema
B
Peripheral oedema
C
Bibasal rales
D
Central pontine demyelination
E
Autonomic dysfunction
Question 6
The hyponatraemic patient undergoes serum osmolality screening and is found to have:
A) a hypotonic state B) Elevated extracellular fluid volume

Which diagnoses best match this profile?
A
CHF
B
Cirrhosis
C
AKI
D
CKD
E
SIADH
Question 6 Explanation: 
Hypervolaemic hypotonic states suggest heart, liver and kidney failure.
Question 7
The patient undergoes serum osmolality screening and is found to have:
A) Hypotonic serum B) Normal extracellular fluid volume 

Which diagnoses best match this profile?
A
Cirrhosis
B
GI loss
C
Third spacing
D
SIADH
E
Hypothyroid
Question 7 Explanation: 
The isovolaemic hypotonic hyponatraemic patient is most likely due to SIADH or corticoid deficiency.
Question 8
The patient undergoes serum osmolality screening and is found to have:
A) an hypotonic state B) low extracellular fluid volume

Which diagnoses best match this profile?
A
Diuretics
B
Adrenal insufficiency
C
Skin loss
D
SIADH
E
AKI
Question 8 Explanation: 
The hypovolaemic hypotonic hyponatraemic patient is more likely to have GI, third space loss or diuresis
Question 9
Where is the hormone most likely responsible for hyponatraemia synthesised?
A
Anterior pituitary gland
B
Hypothalamus
C
Posterior pituitary gland
D
Adrenal gland
E
Pineal gland
Question 9 Explanation: 
ADH is synthesised in the hypothalamus, released by the posterior pituitary gland and causes isovolaemic hypotonic hyponatraemic presentation.
Question 10
Which of the following differentials match to hypovolaemic hyponatraemia?
A
GI loss
B
Water loading
C
SIADH
D
Addison's
E
Brain tumour
Question 11
Which of the following differentials match to euvolaemic hyponatraemia?
A
Diarrhoea
B
Diuretics
C
Ascites
D
Addison's
E
SIADH
Question 12
Which of the following differentials match to hypervolaemic hyponatraemia?
A
Burns
B
Lung cancer
C
Head injury
D
Renal failure
E
Paralytic ileus
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