Dental mock MCQs 1. 600 ml of a concentrated solution of NaCl (400 mOsmol/kg H2O) is infused intravenously.

Which of the following statements is true: A) The extracellular fluid volume decreases, as H2O moves into the cells down an osmotic gradient B) The intracellular osmolality falls C) The intracellular fluid volume decreases, as H2O moves from the cells to the extracellular fluid down an osmotic gradient D) The extracellular osmolality falls Correct answer C: Both NaCl and water are reabsorbed. However, as the concentration of NaCl is higher than in the plasma this will increase the osmolality. The first response of the body is for water to move out of the intracellular compartment into the extracellular compartment. Therefore intracellular volume falls. 2. Thinking about the nephron: A) The proximal tubule is located exclusively in the outer medulla B) Approximately six nephrons feed into one collecting duct C) Each kidney contains 10 million nephrons D) The cells within the loop of Henle are a homogeneous population Correct answer B: Six nephrons feed into one collecting duct. The proximal tubule lies in the cortex. The kidney contains 1 to 1.5 million nephrons. The loop of Henle is made up of three cell types (we only looked at the thick ascending limb). 3. Glomerular filtration: A) Occurs across a filtration barrier which consists of 3 layers B) Removes 80% of the plasma entering the glomerulus C) Occurs across a filtration barrier that consists of 2 layers D) Produces 100 litres/day of filtrate Correct answer A: the layers are formed by the capillary endothelial cells, the basement membrane and the podocytes. 20% of the plasma is removed and 180 litres per day of filtrate is produced. 4. In the cortical collecting duct: A) Principal cells secrete HCO-3 B) Intercalated cells secrete H+ C) H2O reabsorption occurs against an osmotic gradient D) K+ is pumped across the apical membrane of the cells Correct answer B: As I mentioned in the lecture the intercalated cells secrete H+. HCO-3 is not secreted, it is H+ that is secreted (Na+ : H+ exchanger). H2O reabsorption only occurs down an osmotic gradient, never against. The movement of K+ is via K+ channels and the K+ therefore diffuses across the membrane. It is not pumped.

5. Metabolic alkalosis is caused by: A) B) C) D) Ingestion of acidic compounds, e.g. overdose of asprin. Loss of acidic fluid, e.g. in vomiting. Obstructive lung disease. Hyperventilation.

Correct answer B a) Incorrect. This will produce a metabolic acidosis. b) Correct. The loss of acidic fluid from the stomach (i.e. H+) leads to H+ movement into the stomach from the extracellular fluid (to replace the H+ lost). This therefore increases the pH of the extracellular fluid. A metabolic alkalosis. c) Incorrect. Obstructive lung disease will cause respiratory acidosis, as the elimination of CO2 is impaired. d) Incorrect. Hyperventilation will cause a respiratory alkalosis, as the elimination of CO2 is enhanced.