Fluids & Electrolytes — General Medicine

Fluids & Electrolytes MCQs: practice questions

Sample Fluids & Electrolytes multiple-choice questions from General Medicine.

1. A patient has severe hypernatremia after inadequate water intake. Which intracellular change occurs?

   • A. Cell lysis from hypo-osmolality
   • B. Increased intracellular sodium excretion
   • C. Cellular water loss
   • D. Cellular swelling
   • E. Increased intracellular volume

2. A patient with diabetes mellitus has polyuria and becomes dehydrated. Which fluid compartment is initially lost most directly?

   • A. Bone matrix
   • B. Cerebrospinal fluid
   • C. Extracellular fluid
   • D. Pleural space
   • E. Intracellular fluid only

3. A patient with prolonged hypotension develops acute tubular necrosis and oliguria. Which electrolyte abnormality is particularly likely during the oliguric phase?

   • A. Hypocalcemia from diarrhea
   • B. Hypernatremia from water loss
   • C. Hypomagnesemia
   • D. Hyperkalemia
   • E. Hypokalemia

4. A patient with severe renal failure develops metabolic acidosis. Which mechanism contributes?

   • A. Increased ammonium excretion
   • B. Increased bicarbonate generation
   • C. Reduced acid excretion
   • D. Increased distal hydrogen secretion
   • E. Excess pulmonary CO2 elimination

5. A patient develops metabolic acidosis from lactic acid accumulation during shock. Which respiratory response is expected?

   • A. Increased ventilation
   • B. Apnea
   • C. Increased bicarbonate production by the lungs
   • D. Reduced ventilation
   • E. Reduced oxygen consumption only

6. A patient with heart failure develops dependent edema. Which mechanism is most important?

7. A patient with cirrhosis has ascites and low serum albumin. Which additional vascular change promotes fluid accumulation?

8. A patient with severe malnutrition develops edema despite low total body protein. Which mechanism is most important?

9. A patient has severe diarrhea with a normal anion gap metabolic acidosis. Which mechanism best explains the finding?

10. A patient with acute kidney injury becomes oliguric. Which change in fluid balance is most likely if intake continues unchanged?

11. A patient with primary hyperaldosteronism develops hypertension and hypokalemia. Which renal effect of aldosterone explains the hypokalemia?

12. A patient with severe hypoalbuminemia develops generalized edema. Which force has been reduced?

13. A patient with chronic liver disease develops ascites. Which combination best explains the fluid accumulation?

14. A patient with adrenal insufficiency develops hypotension and hyperkalemia. Which hormone deficiency is most directly responsible for the potassium abnormality?

15. A patient with severe hyperkalemia develops muscle weakness and ECG abnormalities. Which complication is most immediately dangerous?

16. A patient has persistent vomiting with volume depletion and metabolic alkalosis. Which renal response helps maintain the alkalosis?

17. A patient with severe dehydration develops prerenal azotemia. Which hemodynamic change is expected?

18. A patient with renal tubular dysfunction develops metabolic acidosis and hypokalemia. Which syndrome is characterized by impaired proximal tubular reabsorption?

19. A patient with congestive heart failure has peripheral edema. Which renal response can worsen the edema?

20. A patient develops generalized edema after a major burn. Which mechanism contributes to the early fluid shift?

21. A patient with nephrotic syndrome develops edema despite normal cardiac function. Which process is most important?

22. A patient with severe diarrhea develops weakness and metabolic acidosis. Which electrolyte disturbance is commonly associated with gastrointestinal bicarbonate loss?

23. A patient receives excessive hypotonic fluid and develops hyponatremia. Which complication is especially dangerous in the brain?

24. A patient with advanced renal failure develops hyperkalemia. Which mechanism best explains the potassium elevation?

25. A patient with chronic respiratory disease retains carbon dioxide. Which acid-base disturbance results?

26. A patient hyperventilates during a panic episode and develops lightheadedness. Which acid-base change is expected?

27. A patient develops shock after massive hemorrhage. Which mechanism is responsible for tissue injury during severe hypoperfusion?

28. A patient develops edema from lymphatic obstruction after cancer surgery. Which mechanism is primarily responsible?

29. A patient with severe vomiting develops hypotension and tachycardia. Which hemodynamic change most directly reflects the volume loss?

30. A patient with severe vomiting develops hypochloremia and weakness. Which electrolyte loss is most directly related to gastric secretions?