LearnWithTest

1 A 42-year-old man is stranded in the desert for 2 days without water. He is severely dehydrated and has serum sodium of 158 mEq/L. Which fluid compartment change best explains his condition?

Isosmotic expansion of extracellular fluid only Hyperosmotic contraction of both extracellular and intracellular compartments Hyposmotic expansion of intracellular compartment only Isosmotic contraction of intracellular compartment only

2 A 6-year-old child has severe watery diarrhea for 3 days. Blood pressure is low, serum sodium is normal. Which compartment abnormality is most likely?

Isosmotic contraction of extracellular fluid only Hyperosmotic expansion of intracellular fluid Hyposmotic expansion of extracellular fluid Hyperosmotic contraction of intracellular fluid only

3 A psychiatric patient drinks 10–12 liters of water daily and presents with seizures. Serum sodium is 115 mEq/L. What is the primary mechanism causing cerebral edema?

Water shifts from intracellular to extracellular compartment Water shifts from extracellular into intracellular compartment Sodium shifts from intracellular to extracellular compartment Protein loss reduces plasma oncotic pressure

4 A trauma patient loses 2 liters of blood rapidly. Which compartment is immediately affected first?

Intracellular fluid volume decreases Plasma volume contracts significantly Interstitial fluid expands initially Total body water increases

5 A patient receives 2 liters of 0.9% normal saline rapidly in the emergency room. Where does most of this infused fluid distribute?

Only intracellular compartment Only extracellular compartment Only plasma compartment Equally into all compartments

6 A neurocritical patient is given hypertonic saline (3% NaCl) for raised intracranial pressure. What is the major fluid shift?

Water moves from extracellular to intracellular space causing swelling Water moves from intracellular to extracellular space shrinking brain cells No osmotic shift occurs because saline stays in plasma only Intracellular sodium increases causing cell expansion

7 A patient with small cell lung carcinoma develops SIADH. Serum sodium is 118 mEq/L with low plasma osmolality. Which disturbance is present?

Hyperosmotic volume contraction Hyposmotic volume expansion affecting both ECF and ICF Isosmotic contraction limited to plasma Hyperosmotic expansion limited to intracellular compartment

8 A child with nephrotic syndrome develops periorbital edema and low serum albumin. What is the primary pathophysiologic mechanism?

Increased plasma oncotic pressure pulling water into vessels Decreased plasma oncotic pressure causing plasma fluid leakage into interstitial space Increased intracellular potassium retention causing swelling Reduced capillary hydrostatic pressure forcing fluid into plasma

9 A patient with congestive heart failure develops pulmonary edema. The main driving force for fluid accumulation is:

Reduced plasma osmolarity Increased capillary hydrostatic pressure Increased plasma oncotic pressure Decreased intracellular sodium concentration

10 A patient with diabetic ketoacidosis has glucose of 700 mg/dL and severe dehydration. Why does intracellular dehydration occur?

Glucose rapidly enters cells increasing intracellular osmolarity Extracellular osmolarity rises pulling water from ICF into ECF Plasma oncotic pressure decreases causing edema Sodium shifts into cells leading to swelling

11 A postoperative patient receives excessive hypotonic IV fluids. Serum sodium falls to 122 mEq/L. Which compartment is most at risk of fatal swelling?

Bone extracellular compartment Brain intracellular compartment Plasma compartment only Synovial transcellular fluid

12 A burn patient loses large plasma proteins through damaged skin. What compartment shift is expected?

Interstitial fluid shifts into plasma restoring volume Plasma fluid shifts into interstitial space causing edema and hypovolemia Intracellular fluid shifts into plasma causing hypervolemia No significant redistribution occurs

13 A patient has persistent vomiting with metabolic alkalosis and volume depletion. Which disturbance is most likely?

Isosmotic contraction of extracellular fluid Hyposmotic expansion of intracellular fluid Hyperosmotic expansion of extracellular fluid Isosmotic expansion of intracellular compartment

14 A cirrhotic patient develops massive ascites. Ascitic fluid is best classified as:

Intracellular fluid Transcellular extracellular fluid Plasma volume Bone fluid compartment

15 A patient with chronic kidney failure retains sodium and water causing generalized edema. This represents:

Hyposmotic volume contraction Hypervolemic extracellular fluid expansion Isosmotic intracellular contraction Pure intracellular edema only