GMS 6440 MAIN EXAMINATION MANUAL 2026/2027
QUESTIONS AND SOLUTIONS RATED A+
✔✔describe hypertonic contraction - ✔✔heavy sweating
loss of excess water without equivalent loss of NaCl
ECF and ICF volume decreases
dehydration
increase in osm
✔✔describe isotonic contraction - ✔✔loss of salt and water in equivalent amounts
examples: diarrhea, vomiting
decrease ECF ONLY
cardiovascular collapse
✔✔describer hypotonic contraction - ✔✔loss of salt without an equivalent loss of water
adrenal insufficiency
fall in ECF
increase in ICF
cell swelling
kidneys cant retain enough sodium
ECF osm decreases, H2O leaves ECF into ICF, cell swells, decrease osm everywhere
✔✔Na ions are major cations in _____ so directional changes in Na concentration
indicate ____________ - ✔✔plasma, osmotic changes
✔✔changes in plasma volume (or ECF volume) causes changes in plasma ______ and
_______ - ✔✔protein; hematocrit
✔✔ICF volume response to changes in ECF osmotic _________ - ✔✔concentration
(NOT VOLUME)
✔✔Hypertonic expansion:
ECF volume:
Plasma [Na+]:
ICF Volume:
Hematocrit:
[Plasma Protein]: - ✔✔Hypertonic expansion:
ECF volume: increase
Plasma [Na+]:incr3ease
ICF Volume: decrease
Hematocrit: decrease
[Plasma Protein]: decrease
✔✔isotonic expansion:
ECF volume:
,Plasma [Na+]:
ICF Volume:
Hematocrit:
[Plasma Protein]: - ✔✔isotonic expansion:
ECF volume: increase
Plasma [Na+]: no change
ICF Volume: no change
Hematocrit: decrease
[Plasma Protein]: decrease
✔✔hypotonic expansion:
ECF volume:
Plasma [Na+]:
ICF Volume:
Hematocrit:
[Plasma Protein]: - ✔✔hypotonic expansion:
ECF volume: increase
Plasma [Na+]: decrease
ICF Volume: increase
Hematocrit: decrease or no change
[Plasma Protein]: decrease
✔✔hypertonic contraction:
ECF volume:
Plasma [Na+]:
ICF Volume:
Hematocrit:
[Plasma Protein]: - ✔✔hypertonic contraction:
ECF volume: decreases
Plasma [Na+]:increases
ICF Volume: decreases
Hematocrit: increases or no change
[Plasma Protein]: increases
✔✔isotonic contraction:
ECF volume:
Plasma [Na+]:
ICF Volume:
Hematocrit:
[Plasma Protein]: - ✔✔isotonic contraction:
ECF volume: decrease
Plasma [Na+]: no change
ICF Volume: no change
Hematocrit: increase
[Plasma Protein]: increase
, ✔✔hypotonic contraction:
ECF volume:
Plasma [Na+]:
ICF Volume:
Hematocrit:
[Plasma Protein]: - ✔✔hypotonic contraction:
ECF volume: decrease
Plasma [Na+]: decrease
ICF Volume: increase
Hematocrit: increase
[Plasma Protein]: increase
✔✔someone is dehydrated, can you administer pure water IV? why? - ✔✔no; the cells
at the infusion site will swell and then burst. that releases K+ into the plasma which can
be fatal (ECF osm is so low H2O enters cells and causes lysis)
because the cell membrane potential is mainly determined by outward diffusion of K+. if
plasma K+ goes up (hyperkalemia) this reduces the outward diffusion of K+ which
depolarizes nerve and muscle and leads to spastic paralysis (respiratory/cardiac
muscle)
✔✔what to administer IV when dehydrated? - ✔✔5% glucose solution because it is iso
osmotic and distributes throughout the ECF
glucose enters the cell and takes water with it
the glucose is metabolized and disappears as a free particle because it gets
incorporated into other larger molecules so it no longer exerts an osmotic effect
✔✔hormones are made from _____ or ______. secreted into the ____________ and
then are carried to _________ - ✔✔hormones are made from endocrine glands or nerve
cells. secreted into the blood and then are carried to target cells
✔✔receptors for water soluble, lipid insoluble hormones are located on the _______ -
✔✔cell surface
✔✔receptors for lipid soluble, water insoluble hormones are located on the _______ -
✔✔intracellular compartment
✔✔there are _________ for each hormone on at the target site - ✔✔specific receptors
QUESTIONS AND SOLUTIONS RATED A+
✔✔describe hypertonic contraction - ✔✔heavy sweating
loss of excess water without equivalent loss of NaCl
ECF and ICF volume decreases
dehydration
increase in osm
✔✔describe isotonic contraction - ✔✔loss of salt and water in equivalent amounts
examples: diarrhea, vomiting
decrease ECF ONLY
cardiovascular collapse
✔✔describer hypotonic contraction - ✔✔loss of salt without an equivalent loss of water
adrenal insufficiency
fall in ECF
increase in ICF
cell swelling
kidneys cant retain enough sodium
ECF osm decreases, H2O leaves ECF into ICF, cell swells, decrease osm everywhere
✔✔Na ions are major cations in _____ so directional changes in Na concentration
indicate ____________ - ✔✔plasma, osmotic changes
✔✔changes in plasma volume (or ECF volume) causes changes in plasma ______ and
_______ - ✔✔protein; hematocrit
✔✔ICF volume response to changes in ECF osmotic _________ - ✔✔concentration
(NOT VOLUME)
✔✔Hypertonic expansion:
ECF volume:
Plasma [Na+]:
ICF Volume:
Hematocrit:
[Plasma Protein]: - ✔✔Hypertonic expansion:
ECF volume: increase
Plasma [Na+]:incr3ease
ICF Volume: decrease
Hematocrit: decrease
[Plasma Protein]: decrease
✔✔isotonic expansion:
ECF volume:
,Plasma [Na+]:
ICF Volume:
Hematocrit:
[Plasma Protein]: - ✔✔isotonic expansion:
ECF volume: increase
Plasma [Na+]: no change
ICF Volume: no change
Hematocrit: decrease
[Plasma Protein]: decrease
✔✔hypotonic expansion:
ECF volume:
Plasma [Na+]:
ICF Volume:
Hematocrit:
[Plasma Protein]: - ✔✔hypotonic expansion:
ECF volume: increase
Plasma [Na+]: decrease
ICF Volume: increase
Hematocrit: decrease or no change
[Plasma Protein]: decrease
✔✔hypertonic contraction:
ECF volume:
Plasma [Na+]:
ICF Volume:
Hematocrit:
[Plasma Protein]: - ✔✔hypertonic contraction:
ECF volume: decreases
Plasma [Na+]:increases
ICF Volume: decreases
Hematocrit: increases or no change
[Plasma Protein]: increases
✔✔isotonic contraction:
ECF volume:
Plasma [Na+]:
ICF Volume:
Hematocrit:
[Plasma Protein]: - ✔✔isotonic contraction:
ECF volume: decrease
Plasma [Na+]: no change
ICF Volume: no change
Hematocrit: increase
[Plasma Protein]: increase
, ✔✔hypotonic contraction:
ECF volume:
Plasma [Na+]:
ICF Volume:
Hematocrit:
[Plasma Protein]: - ✔✔hypotonic contraction:
ECF volume: decrease
Plasma [Na+]: decrease
ICF Volume: increase
Hematocrit: increase
[Plasma Protein]: increase
✔✔someone is dehydrated, can you administer pure water IV? why? - ✔✔no; the cells
at the infusion site will swell and then burst. that releases K+ into the plasma which can
be fatal (ECF osm is so low H2O enters cells and causes lysis)
because the cell membrane potential is mainly determined by outward diffusion of K+. if
plasma K+ goes up (hyperkalemia) this reduces the outward diffusion of K+ which
depolarizes nerve and muscle and leads to spastic paralysis (respiratory/cardiac
muscle)
✔✔what to administer IV when dehydrated? - ✔✔5% glucose solution because it is iso
osmotic and distributes throughout the ECF
glucose enters the cell and takes water with it
the glucose is metabolized and disappears as a free particle because it gets
incorporated into other larger molecules so it no longer exerts an osmotic effect
✔✔hormones are made from _____ or ______. secreted into the ____________ and
then are carried to _________ - ✔✔hormones are made from endocrine glands or nerve
cells. secreted into the blood and then are carried to target cells
✔✔receptors for water soluble, lipid insoluble hormones are located on the _______ -
✔✔cell surface
✔✔receptors for lipid soluble, water insoluble hormones are located on the _______ -
✔✔intracellular compartment
✔✔there are _________ for each hormone on at the target site - ✔✔specific receptors