GMS 6401 EVALUATION TEST ANSWERS AND
QUESTIONS SET A+
✔✔ADH is made in the posterior pituitary gland. - ✔✔F. It is made in hypothalamus and
released from the posterior pituitary gland
✔✔A fall in plasma osmolality of 1% below normal will stimulate ADH release. - ✔✔F.
ADH is released when plasma osmolality increases
✔✔A 2% fall in blood volume will stimulate ADH release. - ✔✔F. Blood volume has to
fall by~10% before ADH is released.
✔✔People with central diabetes insipidus cannot make a concentrated urine. - ✔✔T.
They have no ADH.
✔✔In the syndrome of inappropriate ADH release (SIADH) plasma osmolality
increases. - ✔✔F. It falls because they retain excessive amounts of water
✔✔Normal plasma pH should be slightly alkaline and closely regulated. - ✔✔T. Plasma
pH should be 7.40 and not fall below 7.35 or above 7.45
✔✔Under normal circumstances we are making excess alkali all the time, which has to
beremoved via the lungs and the kidney - ✔✔F. There is continual metabolic production
of mainly organic acids, but also some "fixed" acids from protein metabolism.
✔✔When the CO2 content of the blood increases, the blood becomes more alkaline
(higher pH). - ✔✔F. CO2 is acid and as it increases blood pH falls
✔✔When plasma pH increases, respiration is stimulated. - ✔✔F. Respiration is inhibited
to allow acid CO2 to accumulate and restore the alkaline pH towards normal
, ✔✔The Henderson Hasselbalch equation states that as blood bicarbonate increases
the plasma pH becomes more alkaline. - ✔✔T. pH = pKa + log [HCO3-][PCO2 x 0.03]
✔✔There is no H+ secretion in the proximal tubule. - ✔✔F. There is extensive H+
secretion viaNHE3 (Na -H exchanger) which leads to reabsorption of most (~80%) of
the filteredHCO3
✔✔Proximal net HCO3 reabsorption is facilitated by carbonic anhydrase (CA) in the
lumen. - ✔✔T. Without CA, carbonic acid only breaks down slowly to give water and
CO2, and this CO2 enters the cell and forms a HCO3, which is then reabsorbed
✔✔The kidney makes "new: HCO3 every time an NH4 or a titratable acid is excreted in
the urine - ✔✔True .This process occurs in the collecting duct after most filtered HCO3
has been reabsorbed
✔✔Normally there is no free H+ in the urine. - ✔✔F. Normally urine pH is below 7.0 and
can be as low as 4.5, due to increased H+
✔✔Low pH inhibits renal H+ secretion. - ✔✔F. Low pH stimulates renal H+ secretion to
get rid of the excess H+ in the urine
✔✔A metabolic acid base disturbance means that the primary problem is with plasma
HCO3 control. - ✔✔True. And a respiratory disturbance means PCO2 is the primary
problem
✔✔People with kidney failure are at risk of developing metabolic alkalosis. - ✔✔F.
Because their kidneys cannot excrete the excess acid constantly being metabolized,
they are at risk of metabolic acidosis.
✔✔The plasma anion gap means that there is a difference number of -ve and +ve
charges inthe plasma. - ✔✔F. This would cause lightening! The anion gap is the small #
of unmeasured anions (organic) in plasma, in addition to the measured Cal and HCO3
✔✔Hyperventilation (overbreathing) can lead to respiratory alkalosis. - ✔✔T. By driving
downthe blood PCO2, the body fluids rapidly become alkaline
✔✔As long as plasma pH is 7.4 a person is in perfect acid base balance. - ✔✔F Mixed
acid base disturbances can produce offsetting effects and plasma PCO2, HCO3, and
anion gap should also be assessed
✔✔People with Liddle's syndrome do not have any functional ENaC in the collecting
duct. - ✔✔F. They have excessive and unregulated ENaC activity all the time.
QUESTIONS SET A+
✔✔ADH is made in the posterior pituitary gland. - ✔✔F. It is made in hypothalamus and
released from the posterior pituitary gland
✔✔A fall in plasma osmolality of 1% below normal will stimulate ADH release. - ✔✔F.
ADH is released when plasma osmolality increases
✔✔A 2% fall in blood volume will stimulate ADH release. - ✔✔F. Blood volume has to
fall by~10% before ADH is released.
✔✔People with central diabetes insipidus cannot make a concentrated urine. - ✔✔T.
They have no ADH.
✔✔In the syndrome of inappropriate ADH release (SIADH) plasma osmolality
increases. - ✔✔F. It falls because they retain excessive amounts of water
✔✔Normal plasma pH should be slightly alkaline and closely regulated. - ✔✔T. Plasma
pH should be 7.40 and not fall below 7.35 or above 7.45
✔✔Under normal circumstances we are making excess alkali all the time, which has to
beremoved via the lungs and the kidney - ✔✔F. There is continual metabolic production
of mainly organic acids, but also some "fixed" acids from protein metabolism.
✔✔When the CO2 content of the blood increases, the blood becomes more alkaline
(higher pH). - ✔✔F. CO2 is acid and as it increases blood pH falls
✔✔When plasma pH increases, respiration is stimulated. - ✔✔F. Respiration is inhibited
to allow acid CO2 to accumulate and restore the alkaline pH towards normal
, ✔✔The Henderson Hasselbalch equation states that as blood bicarbonate increases
the plasma pH becomes more alkaline. - ✔✔T. pH = pKa + log [HCO3-][PCO2 x 0.03]
✔✔There is no H+ secretion in the proximal tubule. - ✔✔F. There is extensive H+
secretion viaNHE3 (Na -H exchanger) which leads to reabsorption of most (~80%) of
the filteredHCO3
✔✔Proximal net HCO3 reabsorption is facilitated by carbonic anhydrase (CA) in the
lumen. - ✔✔T. Without CA, carbonic acid only breaks down slowly to give water and
CO2, and this CO2 enters the cell and forms a HCO3, which is then reabsorbed
✔✔The kidney makes "new: HCO3 every time an NH4 or a titratable acid is excreted in
the urine - ✔✔True .This process occurs in the collecting duct after most filtered HCO3
has been reabsorbed
✔✔Normally there is no free H+ in the urine. - ✔✔F. Normally urine pH is below 7.0 and
can be as low as 4.5, due to increased H+
✔✔Low pH inhibits renal H+ secretion. - ✔✔F. Low pH stimulates renal H+ secretion to
get rid of the excess H+ in the urine
✔✔A metabolic acid base disturbance means that the primary problem is with plasma
HCO3 control. - ✔✔True. And a respiratory disturbance means PCO2 is the primary
problem
✔✔People with kidney failure are at risk of developing metabolic alkalosis. - ✔✔F.
Because their kidneys cannot excrete the excess acid constantly being metabolized,
they are at risk of metabolic acidosis.
✔✔The plasma anion gap means that there is a difference number of -ve and +ve
charges inthe plasma. - ✔✔F. This would cause lightening! The anion gap is the small #
of unmeasured anions (organic) in plasma, in addition to the measured Cal and HCO3
✔✔Hyperventilation (overbreathing) can lead to respiratory alkalosis. - ✔✔T. By driving
downthe blood PCO2, the body fluids rapidly become alkaline
✔✔As long as plasma pH is 7.4 a person is in perfect acid base balance. - ✔✔F Mixed
acid base disturbances can produce offsetting effects and plasma PCO2, HCO3, and
anion gap should also be assessed
✔✔People with Liddle's syndrome do not have any functional ENaC in the collecting
duct. - ✔✔F. They have excessive and unregulated ENaC activity all the time.
