3. Hypernatremia.

***) Hypernatremia is known to occur in which of the following: Q2012

1. Syndrome of Inappropriate ADH Secretion (SIADH)

2. Diabetes insipidus

3. Renal failure

4. Hypothyroidism

5. Addison's disease

Answer: B* Diabetes insipidus

***) The Major extracellular cation is:

1. Na – Sodium

2. K – Potassium

3. Mg – Magnesium

4. HCO₃ – Bicarbonate

5. Cl – Chloride

Answer: A* Na – Sodium

***) All of the following are common clinical features in cases of severe hyperntremia, except:

1. Dry mucous membranes

2. Hypothermia

3. Delirium

4. Tachycardia

5. Hypotension

Answer: B* Hypothermia

4. Hyponatremia.

***) Hyponatremia can present with all the following except: Q2012

1. Restlessness

2. Headache

3. Increased appetite

4. Seizures

5. Weakness

Answer: C* Increased appetite

***) All of the following statements are correct about hyponatremia, except:

1. Sodium serum level of 132mEq/L is considered hyponatremia

2. It can be a manifestation of adrenogenital syndrome

3. When correcting hyponatremia, body weight is important in calculating the deficit

4. Hyponatremia does not cause convulsions

5. It may associate with inappropriate antidiuretic hormone syndrome

Answer: D* Hyponatremia does not cause convulsions

***) Concerning hyponatremic dehydration all of the following are true, except:

1. Serum sodium is over 150mmol/L

2. Leads to intracellular dehydration

3. Neurological manifestations may be present

4. The skin is doughy

5. Best management is by rapid rehydration

Answer: A* Serum sodium is over 150mmol/L

5. Syndrome of Inappropriate adh Secretion (siadh).

***) 52 years old male with 20 years history of smoking is admitted to hospital because of cough and weakness. On admission, his serum electrolytes revealed Na 112, K 4.5, Cl 80 and HCO₃ 26. The BUN was 8, serum creatinine 8, and serum uric acid 3. These data are most consistent with one of the following: Q2012

1. Addison's disease

2. Congestive heart failure

3. Cirrhosis with ascites

4. SIADH

5. Myxedema

Answer: D* SIADH

***) SIADH can present with all the following except: Q2012

1. Decreased serum osmolality

2. Decreased serum sodium

3. Increased urine sodium

4. Hyperkalemia

5. Increased urine osmolality

Answer: D* Hyperkalemia

***) Which of the following statements concerning clinical and laboratory findings in patients with inappropriate secretion of antidiuretic hormone is correct:

1. High serum sodium

2. Low urine sodium

3. Low blood pressure

4. May lead to seizures

5. Evidence of dehydration

Answer: D* May lead to seizures

6. Hyperkalemia.

***) 50 years old male patient of DM, HTN, IHD, on the following medications, Statin, insulin, beta blocker, and ACE inhibitors started recently. After 2 weeks he presented with weakness, and the labs showed K 7.1, FBS 300, and CPK 300. The most likely cause of hyperkalemia is: Q2012

1. Hyperglycemia

2. Rhabdomyolysis due to statins

3. ACE inhibitors

4. HTN

5. IHD

Answer: C* ACE inhibitors

***) All of the following are used in the treatment of hyperkalemia, except: Q2012