Fluid-Electrolyte & Renal

PrepBank · পাতা ১ / ২ · ১–১০০ / ১২৮

১.

Forms of calcium excludes

ক
ক) Ionized calcium
খ
খ) Calcium complexed to anions
গ
গ) Protein bound calcium
ঘ
ঘ) Oxidized calcium

সঠিক উত্তর: ঘ

ঘ) Oxidized calcium

উত্তর

সঠিক উত্তর: ঘ

ঘ) Oxidized calcium

ঘ

২.

Substance used to measure RPF?

ক
Sorbitol
খ
PAH
গ
Inulin
ঘ
Mannitol

সঠিক উত্তর: খ

PAH

উত্তর

সঠিক উত্তর: খ

PAH

খ

ব্যাখ্যা

Criteria of a substance, the plasma clearance of which is used for measurement of RPF are:
a) High extraction ratio
c) Not metabolized or produced by kidney
b) Not stored by kidney
d) Non toxic
PAH (para amino hippuric acid) is the substance which fulfills these criteria and can be used for measurement of RPF.
RBF is calculated from RPF by formula:
RBF = RPF 1-Hct
If RPF = 650 ml/min and hematocrit value (Hot) of in 0.45 then RBF1200

৩.

Which part of renal tubule is never permeable to water?

ক
PCT
খ
Thin descending limb
গ
Thin ascending limb
ঘ
DCT

সঠিক উত্তর: গ

Thin ascending limb

উত্তর

সঠিক উত্তর: গ

Thin ascending limb

গ

৪.

Stimulatory of renin secretion

ক
Angiotensin II
খ
Increased Na+ and Cl¯ reabsorption across macula densa
গ
Vasopressin
ঘ
Prostaglandins

সঠিক উত্তর: ঘ

Prostaglandins

উত্তর

সঠিক উত্তর: ঘ

Prostaglandins

ঘ

৫.

Daily water turnover balance by stool

ক
100 ml
খ
150 ml
গ
200 ml
ঘ
300 ml

সঠিক উত্তর: গ

200 ml

উত্তর

সঠিক উত্তর: গ

200 ml

গ

৬.

Which prevents fall of GFR?

ক
ক) Norepinephrine
খ
খ) Epinephrine
গ
গ) Endothelin
ঘ
ঘ) Angiotensin-2

সঠিক উত্তর: ঘ

ঘ) Angiotensin-2

উত্তর

সঠিক উত্তর: ঘ

ঘ) Angiotensin-2

ঘ

৭.

Calculate Renal fraction where CO 5000 ml/min, RBF 1200 ml /min ,RPF 650 ml/min

ক
13%
খ
5.5%
গ
20%
ঘ
24%

সঠিক উত্তর: ঘ

24%

উত্তর

সঠিক উত্তর: ঘ

24%

ঘ

৮.

The glomerular capillaries cannot filtrate...?

ক
ক) Glucose
খ
খ) Plasma protein
গ
গ) Sodium
ঘ
ঘ) Creatinine

সঠিক উত্তর: খ

খ) Plasma protein

উত্তর

সঠিক উত্তর: খ

খ) Plasma protein

খ

ব্যাখ্যা

The renal artery enters the kidney through the hilum and then branches progressively to form the interlobar arteries, arcuate arteries, interlobular arteries (also called radial arteries), and afferent arterioles, which lead to the glomerular capillaries, where large amounts of fluid and solutes (except the plasma proteins) are filtered to begin urine formation.

৯.

The average blood volume of adults is about ... litres?

ক
ক) 5
খ
খ) 7
গ
গ) 9
ঘ
ঘ) 10

সঠিক উত্তর: ক

ক) 5

উত্তর

সঠিক উত্তর: ক

ক) 5

ক

ব্যাখ্যা

The average blood volume of adults is about 7% of body weight, or about 5 litres. About 60% of the blood is plasma and 40% is red blood cells, but these percentages can vary considerably in different people, depending on sex, weight, and other factors.

১০.

What is not the endogenous causes of Normochloremic metabolic acidosis-?

ক
ক) Diabetic ketoacidosis
খ
খ) Renal tubular acidosis
গ
গ) Lactic acidosis
ঘ
ঘ) Renal failure

সঠিক উত্তর: খ

খ) Renal tubular acidosis

উত্তর

সঠিক উত্তর: খ

খ) Renal tubular acidosis

খ

ব্যাখ্যা

Endogenous causes of normochloremic metabolic acidosis are-
-Diabetic ketoacidosis
-Starvation ketosis
-Alcoholic ketoacidosis
-Lactic acidosis
-Kidney disease

১১.

Dehydration increases the plasma concentration of all the following hormones except -?

ক
ক) Vasopressin.
খ
খ) Aldosterone.
গ
গ) Norepinephrine.
ঘ
ঘ) Atrial natriuretic peptide.

সঠিক উত্তর: ঘ

ঘ) Atrial natriuretic peptide.

উত্তর

সঠিক উত্তর: ঘ

ঘ) Atrial natriuretic peptide.

ঘ

ব্যাখ্যা

ANP is called Hypervolemia hormone. It secretion increased during hypervolemia and decreased secretion during dehydration and volume depletion.

১২.

Effect of Antidiuretic hormone

ক
ক) H2O reabsorption
খ
খ) Na+ reabsorption
গ
গ) K+ reabsorption
ঘ
ঘ) Cl- reabsorption

সঠিক উত্তর: ক

ক) H2O reabsorption

উত্তর

সঠিক উত্তর: ক

ক) H2O reabsorption

ক

ব্যাখ্যা

ADH prevents diuresis. It increases reabsorption of H20.

১৩.

Which step of urine formation occurs in glomerulus

ক
Glomerular filtration
খ
Tubular reabsorption
গ
Tubular secretion
ঘ
All

সঠিক উত্তর: ক

Glomerular filtration

উত্তর

সঠিক উত্তর: ক

Glomerular filtration

ক

ব্যাখ্যা

Steps of urine formation
• Glomerular filtration
• Tubular reabsorption
• Tubular secretion.
Among these three processes filtration is the function of the glomerulus. Reabsorption and secretion are the functions of tubular portion of the nephron.

১৪.

Which of the following is a cause of metabolic alkalosis?

ক
ক) Chronic renal failure
খ
খ) Ethylene glycol ingestion
গ
গ) Treatment with acetazolamide
ঘ
ঘ) Hyperaldosteronism

সঠিক উত্তর: ঘ

ঘ) Hyperaldosteronism

উত্তর

সঠিক উত্তর: ঘ

ঘ) Hyperaldosteronism

ঘ

ব্যাখ্যা

A cause of metabolic alkalosis is hyperaldosteronism; increased aldosterone levels cause increased H+ secretion by the distal tubule and increased reabsorption of “new” HCO3–. Diarrhea causes loss of HCO3–from the gastrointestinal (GI) tract and acetazolamide causes loss of HCO3–in the urine, both resulting in hyperchloremic metabolic acidosis with normal anion gap. Ingestion of ethylene glycol and salicylate poisoning leads to metabolic acidosis with increased anion gap.

১৫.

ICF & ISF are separated by

ক
ক) Cell membrane
খ
খ) Cell wall
গ
গ) Plasma membrane
ঘ
ঘ) Capillary membrane

সঠিক উত্তর: ক

ক) Cell membrane

উত্তর

সঠিক উত্তর: ক

ক) Cell membrane

ক

১৬.

Calcium binding capacity of albumin is ------ mmol/g

ক
0.01Calcium binding capacity of albumin is ------ mmol/g
খ
0.02
গ
0.08
ঘ
0.8

সঠিক উত্তর: খ

0.02

উত্তর

সঠিক উত্তর: খ

0.02

খ

ব্যাখ্যা

Calcium binding capacity of albumin is 0.02 mmol/g or 0.8 mg/g

ABC of Biochemistry 6th - P:334

১৭.

Which is not true about urine

ক
Volume 1 ml/min or 1.5 L/day
খ
pH 4.5 to 6.0
গ
Osmolarity 600-900 mosm/L
ঘ
Glucose present

সঠিক উত্তর: ঘ

Glucose present

উত্তর

সঠিক উত্তর: ঘ

Glucose present

ঘ

১৮.

Renin is derived from

ক
ক) Kidney
খ
খ) Liver
গ
গ) Lung
ঘ
ঘ) Adrenal gland

সঠিক উত্তর: ক

ক) Kidney

উত্তর

সঠিক উত্তর: ক

ক) Kidney

ক

ব্যাখ্যা

Explanation:

১৯.

Presence of which particle in urine indicates UTI?

ক
ক) Glucose
খ
খ) Protein
গ
গ) Nitrite
ঘ
ঘ) Bile salt

সঠিক উত্তর: গ

গ) Nitrite

উত্তর

সঠিক উত্তর: গ

গ) Nitrite

গ

ব্যাখ্যা

Presence of nitrite in urine indicates presence of bacteria in urine since some bacteria convert nitrate into nitrite in urine.

২০.

Importance of plasma clearance:

ক
It acts as a marker of renal function
খ
It is used for the measurement of GFR and RPF.
গ
It is used as a guide to determine the effective dose of drugs which are cleared by kidney.
ঘ
All

সঠিক উত্তর: ঘ

All

উত্তর

সঠিক উত্তর: ঘ

All

ঘ

২১.

The glomerular capillaries cannot filtrate...?

ক
ক) Glucose
খ
খ) Plasma protein
গ
গ) Sodium
ঘ
ঘ) Creatinine

সঠিক উত্তর: খ

খ) Plasma protein

উত্তর

সঠিক উত্তর: খ

খ) Plasma protein

খ

ব্যাখ্যা

The renal artery enters the kidney through the hilum and then branches progressively to form the interlobar arteries, arcuate arteries, interlobular arteries (also called radial arteries), and afferent arterioles, which lead to the glomerular capillaries, where large amounts of fluid and solutes (except the plasma proteins) are filtered to begin urine formation.

২২.

Highest conductivity occur in

ক
Skin
খ
Glomerulus
গ
Cardiac muscl
ঘ
Git

সঠিক উত্তর: খ

Glomerulus

উত্তর

সঠিক উত্তর: খ

Glomerulus

খ

২৩.

Hormones responsible for K+ driven into cell excludes-?

ক
ক) Insulin
খ
খ) Epinephrine
গ
গ) Aldosterone
ঘ
ঘ) Glucagon

সঠিক উত্তর: ঘ

ঘ) Glucagon

উত্তর

সঠিক উত্তর: ঘ

ঘ) Glucagon

ঘ

ব্যাখ্যা

Factors increased influx of K+ -
-Insulin
-Aldosterone
-Acute potassium excess
-Alkalosis
-Epinephrine
-Alpha blocker

২৪.

Tetany occurs when plasma calcium level falls below …mg/dl

ক
4
খ
5
গ
6
ঘ
9

সঠিক উত্তর: গ

উত্তর

সঠিক উত্তর: গ

গ

ব্যাখ্যা

Hypoparathyroidism leads to hypocalcemia, by decreasing the resorption of calcium from bones. Hypocalcemia causes neuromuscular hyperexcitability, resulting in hypocalcemic tetany. Normally, tetany occurs when plasma calcium level falls below 6 mg/dL from its normal value of 9.4 mg/dL.

২৫.

Which increases GFR?

ক
ক) Norepinephrine
খ
খ) Epinephrine
গ
গ) Endothelin
ঘ
ঘ) Prostaglandins

সঠিক উত্তর: ঘ

ঘ) Prostaglandins

উত্তর

সঠিক উত্তর: ঘ

ঘ) Prostaglandins

ঘ

২৬.

Which one is gold standard for measurement of GFR?

ক
ক) Inulin clearance
খ
খ) Sodium clearance
গ
গ) Creatinine clearance
ঘ
ঘ) Urea clearance

সঠিক উত্তর: ক

ক) Inulin clearance

উত্তর

সঠিক উত্তর: ক

ক) Inulin clearance

ক

ব্যাখ্যা

Following can be taken as a measure of GFR:
1. Inulin clearance
2. Creatinine clearance and
3. Urea clearance
Inulin clearance – the gold standard of physiologists - is not practical or necessary in clinical practice. Clinically creatinine clearance is widely used. Urea clearance is not an accurate measure of GFR

২৭.

Thirst centre is stimulated by-?

ক
ক) Intracellular dehydration
খ
খ) Decreased E.C.F tonicity
গ
গ) Hypervolemia
ঘ
ঘ) Angiotensin-1

সঠিক উত্তর: ক

ক) Intracellular dehydration

উত্তর

সঠিক উত্তর: ক

ক) Intracellular dehydration

ক

ব্যাখ্যা

Thirst center is stimulated by-
-Intracellular dehydration
-Hypovolemia
-Angiotensin-2 in circulation

২৮.

About what % of human body is fluid?

ক
ক) 40%
খ
খ) 60%
গ
গ) 50 %
ঘ
ঘ) 65 %

সঠিক উত্তর: খ

খ) 60%

উত্তর

সঠিক উত্তর: খ

খ) 60%

খ

ব্যাখ্যা

60% of TBW is fluid where 40% is ICF & 20 is ECF

২৯.

Alpha cell is responsible for

ক
Acid secretion
খ
Base Secretion
গ
Na Absorption
ঘ
K Absorption

সঠিক উত্তর: ক

Acid secretion

উত্তর

সঠিক উত্তর: ক

Acid secretion

ক

৩০.

Whuch of the following not involved in Maintenance stage of metabolic alkalosis

ক
Hypovolemia
খ
Hypocloremia
গ
Hypokalemia
ঘ
Primary hypoaldosteronism

সঠিক উত্তর: ঘ

Primary hypoaldosteronism

উত্তর

সঠিক উত্তর: ঘ

Primary hypoaldosteronism

ঘ

ব্যাখ্যা

ABC of Biochemistry 6th - P: 376

Maintenance stage of metabolic alkalosis
1.Hypovolemia
2.Hypocloremia
3.Hypokalemia
4.Primary hyperaldosteronism

৩১.

Renal autoregulation is important to maintain the

ক
ক) RPF
খ
খ) GFR
গ
গ) BP
ঘ
ঘ) Osmolarity

সঠিক উত্তর: খ

খ) GFR

উত্তর

সঠিক উত্তর: খ

খ) GFR

খ

ব্যাখ্যা

Renal autoregulation is important to maintain the glomerular filtration rate (GFR). Blood flow to kidneys remains normal even when the mean arterial blood pressure vary widely between 60 mm Hg and 180 mmHg. This helps to maintain normal GFR.

৩২.

SGLT 2 is found in

ক
Renal tubule
খ
Renal medulla
গ
Renal cortex
ঘ
Glomerulus

সঠিক উত্তর: ক

Renal tubule

উত্তর

সঠিক উত্তর: ক

Renal tubule

ক

৩৩.

Normal GFR is .... L/day?

ক
ক) 125
খ
খ) 625
গ
গ) 180
ঘ
ঘ) 290

সঠিক উত্তর: গ

গ) 180

উত্তর

সঠিক উত্তর: গ

গ) 180

গ

ব্যাখ্যা

Normally, GFR is about 180 L/day, and tubular reabsorption is 178.5 L/day, leaving 1.5 L/day of fluid to be excreted in the urine.

৩৪.

What is not the example of transcellular fluid-?

ক
ক) CSF
খ
খ) Oedema fluid
গ
গ) Aqueous humor
ঘ
ঘ) Urine

সঠিক উত্তর: খ

খ) Oedema fluid

উত্তর

সঠিক উত্তর: খ

খ) Oedema fluid

খ

ব্যাখ্যা

Transcellular fluids are-
-CSF
-Synovial fluid
-Peritoneal fluid
-Pleural fluid
-pericardial fluid
-Intraocular fluid (Aqueous humor)
-Fluids in the lumen of GIT
-Fluid in lumen of nephron(urine)&Sweat
Oedema fluid is not transcellular fluid.

৩৫.

What is the basic differentiating point between plasma & ISF in case of composition?

ক
Cations
খ
Anions
গ
Protein
ঘ
Phospholipid

সঠিক উত্তর: গ

Protein

উত্তর

সঠিক উত্তর: গ

Protein

গ

ব্যাখ্যা

Interstitial fluid is three-fourths of the ECF. Thus, it is one-fourth of TBW. The composition of interstitial fluid is the same as that of plasma except that it has little protein. Thus, interstitial fluid is an ultrafiltrate of plasma.

৩৬.

Most common form of calcium is

ক
Ionized calcium
খ
Calcium complexed to anions
গ
Protein bound calcium
ঘ
Oxidized calcium

সঠিক উত্তর: ক

Ionized calcium

উত্তর

সঠিক উত্তর: ক

Ionized calcium

ক

৩৭.

A 53-year-old man with HIV suffers a ruptured aortic aneurysm and is rushed into theatre, he undergoes a successful operation and is recovering on the wards in a stable condition. One day after the operation, he becomes oliguric with mildly elevated urea and creatinine. After 1 week, he becomes polyuric with a GFR of 30. The most likely diagnosis is:

ক
Haemolytic-uraemic syndrome
খ
SIADH
গ
Acute tubular necrosis
ঘ
HIV nephropathy

সঠিক উত্তর: গ

Acute tubular necrosis

উত্তর

সঠিক উত্তর: গ

Acute tubular necrosis

গ

ব্যাখ্যা

Acute tubular necrosis is most commonly due to renal ischaemia, as in this case, though direct pharmacological toxicity can also be the cause among many others including haemorrhage, diuretics, contrast during radiological procedures and heart failure. The clinical course is dependent on the offending factor and degree of damage but most commonly early oliguria followed by recovery of renal function with an increase in renal output. GFR, however, may remain low due to tubular damage. Full renal capacity is usually regained within 6 weeks of the initial stressor. Haemolytic uraemic syndrome (HUS) (A) defines the acute injury to the kidney from RBC fragmentation which usually originates from thrombosis within arteries. HUS is therefore the triad of microangiopathic haemolysis, thrombocytopenia

৩৮.

Intracellular fluid contains large amount of

ক
Glucose
খ
Na
গ
K
ঘ
Bicarbonate

সঠিক উত্তর: গ

উত্তর

সঠিক উত্তর: গ

গ

৩৯.

A fall in plasma Na+ concentration -?

ক
ক) results from excessive production of ADH
খ
খ) Decreases intracellular fluid volume
গ
গ) Increases plasma osmolarity
ঘ
ঘ) Is likely to cause thirst

সঠিক উত্তর: ক

ক) results from excessive production of ADH

উত্তর

সঠিক উত্তর: ক

ক) results from excessive production of ADH

ক

ব্যাখ্যা

Reference- Rodde physiology/6th/Q-48

৪০.

To maintain normal H+ balance, total daily excretion of H+ should equal the daily

ক
Fixed acid production plus fixed acid ingestion
খ
HCO3− excretion
গ
HCO3− filtered load
ঘ
Titratable acid excretion

সঠিক উত্তর: ক

Fixed acid production plus fixed acid ingestion

উত্তর

সঠিক উত্তর: ক

Fixed acid production plus fixed acid ingestion

ক

ব্যাখ্যা

Total daily production of fixed H+ from catabolism of proteins and phospholipids (plus any additional fixed H+ that is ingested) must be matched by the sum of excretion of H+ as titratable acid plus NH4+ to maintain acid–base balance.

৪১.

Calculate HCO3 deficit in a 70 kg man,measured HCO3=20 mmol/l

ক
140
খ
150
গ
110
ঘ
160

সঠিক উত্তর: ক

140

উত্তর

সঠিক উত্তর: ক

140

ক

ব্যাখ্যা

HCO₃ deficit= ( Normal HCO₃- Measured HCO³)* HCO₃ space

HCO₃ space=30-50 % of TBW

৪২.

Cause of metabolic alkalosis

ক
Chronic hyperkalemia
খ
Hypercloremia
গ
Bartter syndrome
ঘ
CAI

সঠিক উত্তর: গ

Bartter syndrome

উত্তর

সঠিক উত্তর: গ

Bartter syndrome

গ

ব্যাখ্যা

ABC of Biochemistry 6th - P: 374

৪৩.

Macula Densa is accocied with following ion

ক
K
খ
Ca
গ
HCO3
ঘ
Na

সঠিক উত্তর: ঘ

উত্তর

সঠিক উত্তর: ঘ

ঘ

৪৪.

Chronic hyponatremia shows -----% mortatility

ক
6
খ
29
গ
4
ঘ
50

সঠিক উত্তর: ক

উত্তর

সঠিক উত্তর: ক

ক

ব্যাখ্যা

ABC of Biochemistry 6th - P:319

৪৫.

Mismatch regarding lab finding of respiratory alkalosis

ক
increased K
খ
Decreased Cl
গ
Anion gap= Normal
ঘ
Base excess negative

সঠিক উত্তর: ঘ

Base excess negative

উত্তর

সঠিক উত্তর: ঘ

Base excess negative

ঘ

ব্যাখ্যা

ABC biochem 7th -401

৪৬.

Which part of renal tubule is never permeable to NaCl?

ক
ক) PCT
খ
খ) Thin descending limb
গ
গ) Thin ascending limb
ঘ
ঘ) Thick ascending limb

সঠিক উত্তর: ঘ

ঘ) Thick ascending limb

উত্তর

সঠিক উত্তর: ঘ

ঘ) Thick ascending limb

ঘ

৪৭.

Net filtration pressure ___mm Hg

ক
ক) 60
খ
খ) 18
গ
গ) 32
ঘ
ঘ) 10

সঠিক উত্তর: ঘ

ঘ) 10

উত্তর

সঠিক উত্তর: ঘ

ঘ) 10

ঘ

ব্যাখ্যা

10 mmHg net filtration pressure cause filtration in the glomerulus.

৪৮.

What is the value of renal plasma flow (ml/min)?

ক
1
খ
125
গ
500
ঘ
625

সঠিক উত্তর: ঘ

625

উত্তর

সঠিক উত্তর: ঘ

625

ঘ

৪৯.

About what % of human body is fluid?

ক
40%
খ
60%
গ
50 %
ঘ
65 %

সঠিক উত্তর: খ

60%

উত্তর

সঠিক উত্তর: খ

60%

খ

ব্যাখ্যা

60% of TBW is fluid where 40% is ICF & 20 is ECF

৫০.

Regarding Primary Polydipsia which is incorrect

ক
Decreasec serum ADH
খ
Low urine osmolarity
গ
Urine Na > 20 mmol/l
ঘ
intake is >20 L /d

সঠিক উত্তর: ঘ

intake is >20 L /d

উত্তর

সঠিক উত্তর: ঘ

intake is >20 L /d

ঘ

ব্যাখ্যা

ABC of Biochemistry 6th - P:318

৫১.

Which is not a biochemical defect in RTA

ক
Decreased tubular hydrogen ion secretion
খ
Failure of ammmoniagenesis
গ
Failure of volatile acid secretion
ঘ
Failure of HCO3 reabsorption

সঠিক উত্তর: গ

Failure of volatile acid secretion

উত্তর

সঠিক উত্তর: গ

Failure of volatile acid secretion

গ

ব্যাখ্যা

ABC of Biochemistry 6th - P: 373

৫২.

In respiratory acidosis,renal compensation is not done by

ক
Complete reabsorption of filtrated HCO3
খ
increased renal acid excretion
গ
increased renal acid secretion
ঘ
Increased ammoniagenesis

সঠিক উত্তর: গ

increased renal acid secretion

উত্তর

সঠিক উত্তর: গ

increased renal acid secretion

গ

ব্যাখ্যা

ABC of Biochemistry 6th - P: 382

৫৩.

Which is not a Criteria of a substance, the plasma clearance of which is used for measurement of GFR are

ক
albumin bound
খ
Neither reabsorbed nor secreted by tubules
গ
Not metabolize
ঘ
Non toxic

সঠিক উত্তর: ক

albumin bound

উত্তর

সঠিক উত্তর: ক

albumin bound

ক

ব্যাখ্যা

Criteria of a substance, the plasma clearance of which is used for measurement of GFR are:
a) Freely filtered (not albumin bound),
b) Neither reabsorbed nor secreted by tubules
c) Not metabolized or produced by kidney
d) Non toxic

৫৪.

Which is the open end buffer system of our body

ক
Phosphate
খ
Bicarbonate
গ
Hb
ঘ
Protein

সঠিক উত্তর: খ

Bicarbonate

উত্তর

সঠিক উত্তর: খ

Bicarbonate

খ

ব্যাখ্যা

ABC of Biochemistry 6th - P: 349

৫৫.

Non-Lethal value of body pH

ক
6.5
খ
8.2
গ
6.8
ঘ
7.0

সঠিক উত্তর: ঘ

7.0

উত্তর

সঠিক উত্তর: ঘ

7.0

ঘ

ব্যাখ্যা

Explanations:
Normal pH value is 7.4 and lethal values only about 0.5 on either side of normal.

৫৬.

Interstitial fluid is an ultrafiltrate of

ক
ক) Plasma
খ
খ) Total body fluid
গ
গ) ICF
ঘ
ঘ) Protein

সঠিক উত্তর: ক

ক) Plasma

উত্তর

সঠিক উত্তর: ক

ক) Plasma

ক

ব্যাখ্যা

৫৭.

Common unmeasured anion in plasma is _________________meq/L

ক
10
খ
15
গ
20
ঘ
25

সঠিক উত্তর: ঘ

উত্তর

সঠিক উত্তর: ঘ

ঘ

ব্যাখ্যা

ABC of Biochemistry 6th - P: 366

৫৮.

Antacid is

ক
Colloid
খ
Crystaloid
গ
Suspension
ঘ
True solution

সঠিক উত্তর: গ

Suspension

উত্তর

সঠিক উত্তর: গ

Suspension

গ

৫৯.

In case of 70kg adult, Extracellular fluid contains;

ক
40% of body weight
খ
30% of body weight
গ
20% of body weight
ঘ
15% of body weight

সঠিক উত্তর: গ

20% of body weight

উত্তর

সঠিক উত্তর: গ

20% of body weight

গ

৬০.

Which of the following substances or combinations of substances could be used to measure interstitial fluid volume?

ক
ক) Mannitol
খ
খ) Evans blue
গ
গ) Inulin and D2O
ঘ
ঘ) Inulin and radioactive albumin

সঠিক উত্তর: ঘ

ঘ) Inulin and radioactive albumin

উত্তর

সঠিক উত্তর: ঘ

ঘ) Inulin and radioactive albumin

ঘ

ব্যাখ্যা

Interstitial fluid volume is measured indirectly by determining the difference between extracellular fluid (ECF) volume and plasma volume. Inulin, a large fructose polymer that is restricted to the extracellular space, is a marker for ECF volume. Radioactive albumin is a marker for plasma volume.

৬১.

The percentage of TBW is highest in...

ক
ক) Newborns
খ
খ) Adult male
গ
গ) Adult female
ঘ
ঘ) Elderly

সঠিক উত্তর: ক

ক) Newborns

উত্তর

সঠিক উত্তর: ক

ক) Newborns

ক

ব্যাখ্যা

Total body water (TBW) is approximately 60% of body weight. Body water is inversely proportional to body fat. The percentage of TBW is highest in newborns then in adult males and lowest in adult females and in adults with a large amount of adipose tissue.

৬২.

Urine volume can be as low as ... L/day in a dehydrated person?

ক
0.5
খ
1.0
গ
1.5
ঘ
2.0

সঠিক উত্তর: ক

0.5

উত্তর

সঠিক উত্তর: ক

0.5

ক

ব্যাখ্যা

306

Urine volume can be as low as 0.5 L/day in a dehydrated person or as high as 20 L/day in a person who has been drinking tremendous amounts of water.

৬৩.

A 32-year-old builder presents in accident and emergency in a distressed state. He reports suffering from chest pain for the last 2 weeks, the pain is sharp and only occurs when he moves heavy objects. He has a family history of cardiovascular disease and is worried about a heart attack. His blood gas findings are as follows: pH = 7.47; PCO2 = 3.3; PO2 = 15.3; bicarbonate = 17.53. The most likely diagnosis is:

ক
Respiratory acidosis with metabolic compensation
খ
Acute respiratory alkalosis
গ
Metabolic acidosis with respiratory compensation
ঘ
Acute metabolic acidosis

সঠিক উত্তর: খ

Acute respiratory alkalosis

উত্তর

সঠিক উত্তর: খ

Acute respiratory alkalosis

খ

ব্যাখ্যা

The history in this case suggests the patient's chest pain is due to muscular injury rather than anything more sinister. The patient's anxiety about cardiovascular morbidity has ultimately resulted in hyperventilation causing an acute respiratory alkalosis . Acid base abnormalities can be solved by either considering the Henderson-Hasselbach equation (CO2 + H2O → H2CO3 → H+ + HCO3-), whereby change in the product(s) on one side of the equation is balanced by a shift in equilibrium. For example, in this case the patient's hyperventilation causes a reduction in CO2, in order to increase the CO₂ the equilibrium shifts towards CO₂ + H₂O which causes a reduction in H+ (alkalosis) and HCO3-. This process occurs in respiratory alkalosis with metabolic compensation (C). If the patient had a true cardiac arrest it would cause a surge in lactic acidosis hence H+ concentration increases causing a metabolic acidosis (B). In order to balance this change, the equilibrium shifts away from H+ and causes increased CO2 production which can manifest as an increased respiratory rate, otherwise called 'metabolic acidosis with respiratory compensation' (D). In a respiratory acidosis with metabolic compensation (A) scenario, a patient may have a respiratory abnormality such as chronic hypoventilation. The accumulation of CO2 which leads to increased H+ is compensated for by bicarbonate which is subsequently reduced. In more chronic conditions, the bicarbonate becomes elevated.

৬৪.

At high altitude there is increase in

ক
pCO2
খ
pO2.
গ
Plasma HCO3
ঘ
Acidosis

সঠিক উত্তর: গ

Plasma HCO3

উত্তর

সঠিক উত্তর: গ

Plasma HCO3

গ

৬৫.

Clinical safe range of pH is

ক
4.5-6
খ
5.5-8
গ
7-8
ঘ
7.3-7.5

সঠিক উত্তর: ঘ

7.3-7.5

উত্তর

সঠিক উত্তর: ঘ

7.3-7.5

ঘ

ব্যাখ্যা

Clinical safe range of pH is 7.3-7.5

ABC of Biochemistry 6th - P:342

৬৬.

A raised blood pH & Bicarbonate level is consistent with-?

ক
ক) Persistant vomiting of gastric content
খ
খ) Chronic renal failure with raised PC02
গ
গ) A reduced PCO2
ঘ
ঘ) Partly compensated respiratory alkalosis

সঠিক উত্তর: ক

ক) Persistant vomiting of gastric content

উত্তর

সঠিক উত্তর: ক

ক) Persistant vomiting of gastric content

ক

ব্যাখ্যা

Metabolic effects of prolonged vomiting are-
-Metabolic alkalosis
-Hypovolemia leading to lactic acidosis
-Hypokalemia
-Hypochloremia
-Paradoxical aciduria
-Compensatory hypoventilation

৬৭.

Erythropoietin is secreted by-?

ক
ক) cells in the proximal tubules.
খ
খ) cells in the distal tubules.
গ
গ) granular cells in the juxtaglomerular apparatus.
ঘ
ঘ) Cells in the peritubular capillary bed.

সঠিক উত্তর: ঘ

ঘ) Cells in the peritubular capillary bed.

উত্তর

সঠিক উত্তর: ঘ

ঘ) Cells in the peritubular capillary bed.

ঘ

ব্যাখ্যা

Erythropoietin is produced by interstitial cells in the peritubular capillary bed of the kidneys and by perivenous hepatocytes in the liver.

৬৮.

Fluid output through sweat (ml) in normal condition?

ক
ক) 100
খ
খ) 200
গ
গ) 350
ঘ
ঘ) 500

সঠিক উত্তর: ক

ক) 100

উত্তর

সঠিক উত্তর: ক

ক) 100

ক

৬৯.

Longest Part of Nephron

ক
Loop of Henle
খ
DCT
গ
PCT
ঘ
CD

সঠিক উত্তর: গ

PCT

উত্তর

সঠিক উত্তর: গ

PCT

গ

৭০.

A raised blood pH & Bicarbonate level is consistent with-?

ক
ক) Persistent vomiting of gastric content
খ
খ) Chronic renal failure with raised PC02
গ
গ) Partly compensated respiratory alkalosis
ঘ
ঘ) Metabolic acidosis

সঠিক উত্তর: ক

ক) Persistent vomiting of gastric content

উত্তর

সঠিক উত্তর: ক

ক) Persistent vomiting of gastric content

ক

ব্যাখ্যা

Metabolic effects of prolonged vomiting are-
-Metabolic alkalosis
-Hypovolemia leading to lactic acidosis
-Hypokalemia
-Hypochloremia
-Paradoxical aciduria
-Compensatory hypoventilation

৭১.

Standard scale to measure Plasma Bicarbonate Conc

ক
Temp 37 C
খ
Venous PCO2 40 mmHg
গ
Hb Conc 15 mg/dl
ঘ
O2 saturation 94%

সঠিক উত্তর: ক

Temp 37 C

উত্তর

সঠিক উত্তর: ক

Temp 37 C

ক

ব্যাখ্যা

_{ABC of Biochemistry 6th - P: 352}

৭২.

Specific gravity of urine is low in

ক
DM
খ
DI
গ
CRF
ঘ
AKI

সঠিক উত্তর: খ

উত্তর

সঠিক উত্তর: খ

খ

ব্যাখ্যা

Specific gravity of urine is the measure of dissolved solutes (particles) in urine. It is low in diabetes insipidus and high in diabetes mellitus, acute renal failure and excess medications.

৭৩.

Autoregulation range of RBF is

ক
below 80 mmHg
খ
above 180 mm Hg
গ
80/120 mmHg
ঘ
80-180 mmHg

সঠিক উত্তর: ঘ

80-180 mmHg

উত্তর

সঠিক উত্তর: ঘ

80-180 mmHg

ঘ

৭৪.

Severe Hypotonicity of ECF compared to ICF may lead to-?

ক
ক) Cellular overhydration
খ
খ) Cerebral oedema
গ
গ) Cellular dehydration
ঘ
ঘ) Hyperkalemia

সঠিক উত্তর: খ

খ) Cerebral oedema

উত্তর

সঠিক উত্তর: খ

খ) Cerebral oedema

খ

ব্যাখ্যা

Reference-Davidson/23rd/P-435/Fig-16.6

৭৫.

Calculate HCO3 space in a 70 kg man when HCO3 conc 24 mmol/l

ক
33
খ
32
গ
31
ঘ
40

সঠিক উত্তর: খ

উত্তর

সঠিক উত্তর: খ

খ

ব্যাখ্যা

HCO₃space= (0.36+ 2.44/HCO₃ conc) * BW

ABC of Biochemistry 6th - P:352

৭৬.

Organic substances excreted in urine excludes

ক
ক) Urea
খ
খ) Uric acid
গ
গ) Sulfate
ঘ
ঘ) Creatinine

সঠিক উত্তর: গ

গ) Sulfate

উত্তর

সঠিক উত্তর: গ

গ) Sulfate

গ

৭৭.

The average blood volume of adults is about ... of body weight?

ক
5%
খ
7%
গ
9%
ঘ
10%

সঠিক উত্তর: খ

উত্তর

সঠিক উত্তর: খ

খ

ব্যাখ্যা

৭৮.

Glomerular colloid osmotic pressure (mmHg)

ক
ক) 10
খ
খ) 18
গ
গ) 32
ঘ
ঘ) 60

সঠিক উত্তর: গ

গ) 32

উত্তর

সঠিক উত্তর: গ

গ) 32

গ

৭৯.

Which pair is correct regarding working site of buffer

ক
Bicorbonate- mostly ICF
খ
Phoaphate- mostly ECF
গ
Protein-Mostly ICF
ঘ
Ammonia-Mostly ECF

সঠিক উত্তর: গ

Protein-Mostly ICF

উত্তর

সঠিক উত্তর: গ

Protein-Mostly ICF

গ

ব্যাখ্যা

ABC of Biochemistry 6th - P:345

৮০.

Biochemical changes occur following prolonged vomiting are-?

ক
ক) Metabolic acidosis
খ
খ) Hypernatremia
গ
গ) Hypokalemia
ঘ
ঘ) Hypoalbuminemia

সঠিক উত্তর: গ

গ) Hypokalemia

উত্তর

সঠিক উত্তর: গ

গ) Hypokalemia

গ

ব্যাখ্যা

Metabolic effects of prolonged vomiting are-
-Metabolic alkalosis
-Hypovolemia leading to lactic acidosis
-Hypokalemia
-Hypochloremia
-Paradoxical aciduria
-Compensatory hypoventilation

৮১.

Hypertonic Hypervolemia occur in

ক
CLD
খ
NS
গ
Conn's Syndrome
ঘ
CCF

সঠিক উত্তর: গ

Conn's Syndrome

উত্তর

সঠিক উত্তর: গ

Conn's Syndrome

গ

ব্যাখ্যা

ABC of Biochemistry 6th - P:310

৮২.

ICF contains large amount of all of the following except

ক
ক) Potassium
খ
খ) Chloride
গ
গ) Phosphate
ঘ
ঘ) Magnesium

সঠিক উত্তর: খ

খ) Chloride

উত্তর

সঠিক উত্তর: খ

খ) Chloride

খ

৮৩.

Which of the following causes increased aldosterone secretion?

ক
ক) Decreased blood volume
খ
খ) Administration of an inhibitor of angiotensin-converting enzyme (ACE)
গ
গ) Hyperosmolarity
ঘ
ঘ) Hypokalemia

সঠিক উত্তর: ক

ক) Decreased blood volume

উত্তর

সঠিক উত্তর: ক

ক) Decreased blood volume

ক

ব্যাখ্যা

Explanation-
★ Decreased blood volume stimulates the secretion of renin (because of decreased renal perfusion pressure) and initiates the renin–angiotensinaldosterone cascade. Angiotensin-converting enzyme (ACE) inhibitors block the cascade by decreasing the production of angiotensin II. Hyperosmolarity stimulates antidiuretic hormone (ADH) [not aldosterone] secretion. Hyperkalemia, not hypokalemia, directly stimulates aldosterone secretion by the adrenal cortex.
Reference-Ganong physiology/26th/P-348/T-20.6 & BRS physiology/6th/P-244

৮৪.

Substances that freely filtered but not reabsorbed by the kidney -

ক
ক) Urea
খ
খ) Glucose
গ
গ) Bicarbonate
ঘ
ঘ) Inulin

সঠিক উত্তর: ঘ

ঘ) Inulin

উত্তর

সঠিক উত্তর: ঘ

ঘ) Inulin

ঘ

ব্যাখ্যা

That is why inulin clearance is used for measurement of GFR.

৮৫.

Presence of positive benedict's test indicate that there might be a problem in

ক
ক) PCT
খ
খ) DCT
গ
গ) LOH
ঘ
ঘ) CD

সঠিক উত্তর: ক

ক) PCT

উত্তর

সঠিক উত্তর: ক

ক) PCT

ক

ব্যাখ্যা

Benedict test is used to detect glucose which is reabsorbed in PCT.

৮৬.

Renin is secreted from

ক
ক) Macula densa
খ
খ) Juxtaglomerular cell
গ
গ) mesangial cells
ঘ
ঘ) Lacis cells

সঠিক উত্তর: খ

খ) Juxtaglomerular cell

উত্তর

সঠিক উত্তর: খ

খ) Juxtaglomerular cell

খ

ব্যাখ্যা

JG cells secrets renin.

৮৭.

Internal environment

ক
ক) ICF
খ
খ) ISF
গ
গ) ECF
ঘ
ঘ) All of them

সঠিক উত্তর: গ

গ) ECF

উত্তর

সঠিক উত্তর: গ

গ) ECF

গ

৮৮.

Im absence of vasopressin, the greatest fraction of filtered water is reabsorbed in the-?

ক
ক) DCT
খ
খ) PCT
গ
গ) ALLH
ঘ
ঘ) DLLH

সঠিক উত্তর: খ

খ) PCT

উত্তর

সঠিক উত্তর: খ

খ) PCT

খ

ব্যাখ্যা

Aquaporin-1 is localized to both the basolateral and apical membrane of the proximal tubules and its presence allows water to move rapidly out of the tubule along the osmotic gradients set up by active transport of solutes, and isotonicity is maintained. 60-70% of filtered water is reabsorbed in PCT.

৮৯.

Regarding Osmoregulation which one is incorrect

ক
Sensor- Baro receptor
খ
Effector organ-Kidney
গ
Effector-GFR
ঘ
Pattern of response -Quick

সঠিক উত্তর: ঘ

Pattern of response -Quick

উত্তর

সঠিক উত্তর: ঘ

Pattern of response -Quick

ঘ

ব্যাখ্যা

ABC of Biochemistry 6th -308

৯০.

Renal Ammoniagenesis occur mostly in

ক
PCT
খ
DCT
গ
ALLH
ঘ
CD

সঠিক উত্তর: ক

PCT

উত্তর

সঠিক উত্তর: ক

PCT

ক

৯১.

What is the normal value of fluid (ml) we get from metabolism?

ক
100
খ
200
গ
350
ঘ
500

সঠিক উত্তর: খ

200

উত্তর

সঠিক উত্তর: খ

200

খ

৯২.

Which decreases PO4- reabsorption?

ক
ক) ADH
খ
খ) Aldosterone
গ
গ) ANP
ঘ
ঘ) PTH

সঠিক উত্তর: ঘ

ঘ) PTH

উত্তর

সঠিক উত্তর: ঘ

ঘ) PTH

ঘ

৯৩.

Normally tubular reabsorption is ___ L/day?

ক
ক) 1.5
খ
খ) 178.5
গ
গ) 180
ঘ
ঘ) 125

সঠিক উত্তর: খ

খ) 178.5

উত্তর

সঠিক উত্তর: খ

খ) 178.5

খ

ব্যাখ্যা

Normally, GFR is about 180 L/day, and tubular reabsorption is 178.5 L/day, leaving 1.5 L/day of fluid to be excreted in the urine.

৯৪.

Plasma protein is increased in

ক
Leprosy
খ
Malaria
গ
Nephrotic syndrome
ঘ
Prematurity

সঠিক উত্তর: ক

Leprosy

উত্তর

সঠিক উত্তর: ক

Leprosy

ক

ব্যাখ্যা

Explanations:
Plasma protein is increased in
• Dehydration
• Autoimmune disease
• Multiple myeloma
• Sarcoidosis
• Leprosy

৯৫.

A 38-year-old woman presents to her GP with a 2-week history of dysuria, haematuria and shortness of breath. She suffers from chronic headaches and has been taking ibuprofen in order to treat them. She has a history of cardiovascular disease in the family and a friend recommended she use aspirin to keep healthy. The most appropriate investigation is:

ক
Retrograde pyelography
খ
Renal biopsy
গ
CT scan of the kidney
ঘ
Antegrade pyelography

সঠিক উত্তর: গ

CT scan of the kidney

উত্তর

সঠিক উত্তর: গ

CT scan of the kidney

গ

ব্যাখ্যা

This patient is most likely suffering from analgesic nephropathy in view of the chronic history of NSAID consumption. Chronic intake can result in papillary necrosis and tubulointerstitial nephritis leading to anaemia, UTIs and haematuria. Diagnosis is made by ultrasound or CT scan alongside this clinical picture. An ultrasound is particularly useful if patients complain of sudden flank pain which can result from sloughed papillae causing urinary obstructions. Antegrade pyelography (D) is used to investigate a potential area of obstruction within the kidney which is not indicated in this case. Retrograde pyelography (A) is conducted to investigate obstructions via a catheter. A renal biopsy (B) would be useful to assess the degree of damage to the kidney but this is not essential as stopping analgesics or replacing them with alternatives, such as paracetamol, can reduce or even improve the condition. An abdominal x-ray alone would not be a useful modality for revealing renal damage in this case (C).

৯৬.

Blood is detected in urine by

ক
Orthotolidine test
খ
Rotheras test
গ
Hay surface tension test
ঘ
Fouchers test

সঠিক উত্তর: ক

Orthotolidine test

উত্তর

সঠিক উত্তর: ক

Orthotolidine test

ক

ব্যাখ্যা

Orthotolidine test is used to detect blood in urine.

৯৭.

Interstitial Fluid pressure in Epidural space

ক
-8 mm Hg
খ
-4 to -6 mm Hg
গ
6 mm Hg
ঘ
4 mm Hg

সঠিক উত্তর: খ

-4 to -6 mm Hg

উত্তর

সঠিক উত্তর: খ

-4 to -6 mm Hg

খ

ব্যাখ্যা

• Intrapleural space: -8 mm Hg
• Joint synovial spaces: -4 to -6 mm Hg
• Epidural space: -4 to -6 mm Hg

৯৮.

Clearance value of inulin

ক
0
খ
50
গ
100
ঘ
125

সঠিক উত্তর: ঘ

125

উত্তর

সঠিক উত্তর: ঘ

125

ঘ

৯৯.

Compared with intracellular fluid, extra-cellular fluid has

ক
ক) a greater osmolarity
খ
খ) a higher protein concentration
গ
গ) a lower chloride ion concentration
ঘ
ঘ) a lower potassium ion concentration

সঠিক উত্তর: ঘ

ঘ) a lower potassium ion concentration

উত্তর

সঠিক উত্তর: ঘ

ঘ) a lower potassium ion concentration

ঘ

ব্যাখ্যা

Osmolarity is equal both ECF&ICF.
In ICF-protein content is high.
In ECF- High content of Na+, Cl-, Ca++

১০০.

Most of the absorption takes place in

ক
ক) PCT
খ
খ) DCT
গ
গ) LOH
ঘ
ঘ) CD

সঠিক উত্তর: ক

ক) PCT

উত্তর

সঠিক উত্তর: ক

ক) PCT

ক

ব্যাখ্যা

PCT has maximum capacity of reabsorption. Most of the reabsorption takes place here.