FLUIDS AND ELECTROLYTES 9.

Oral rehydration may not be used in the following

Dr. Lorenzana dehydration:
1. Reduced food intake cause nutritional decline due to a. Isonatremic
diarrhea because of the following, EXCEPT: b. Hyponatremic
a. Witholding of food to “rest the bowel” c. Hypernatremic
b. Food given often with reduced nutrient value eg. d. None
Soup, thin porridge 10. The highest incidence of diarrhea is in the age group:
c. Rapid transit of food in the cut a. 0-5mos
d. Anorexia which can be marked b. 6-11mos
e. None of the above c. 1-2 mos
2. The physiologic acidosis in the newborn is due to the d. 2-5 mos
a. Lower concentration of serum chloride e. 5-20mos
b. Lower concentration of serum bicarbonate 11. When the infant with diarrhea has lost 5-10% of his
c. Lower concentration of serum potassium body weight over 2 days, all of the following may be
d. A&B expected, EXCEPT?
e. None of the above a. Depressed fontanels
3. A case of a 4y/o boy was seen at the ER due to b. Tachycardia
profuse stools and occasional vomiting. He was c. Thready pulse
irritable with sunken eyeballs and dry lips, skin pinch d. Sunken eyeballs
goes back slowly. Wt – 16kg. Assess the degree of e. Loss of skin elasticity
dehydration 12. Minute local subarachnoid hemorrhages occur most
a. No signs of dehydration often in:
b. Some dehydration a. Hypokalemia
c. Severe dehydration b. Hypernatremia
4. Initial fluid management for the above case: c. Hyperkalemia
a. LR to run 480cc 1st hour d. Hypercalcemia
b. Oresol 480cc 1st hour e. None
c. LR to run 480cc 1st 30 mins 13. Recommended drug for Giardia Diarrhea
d. Oresol 300 1st hr a. Tetracycline
e. None of the above b. Ampicillin
5. The most acceptable solution for oral rehydration of c. Metronidazole
infants with diarrhea with some dehydration d. Cefriaxone
presumably caused by e.coli has composition/L. 14. Decreased absorption of nutrients in diarrhea is due
a. Na+ 75meq; K+ 15meq; Cl- 65meq, 75mmol to the following causes(s):
b. Glucose 4g/dL in isotonic saline (Na+ 150 meq; a. Reduced intestinal concentration of bile salts
Cl- 150meq) b. Disaccharide enzyme deficiency
c. Na+ 10meq, K+ 15meq; Cl- 25meq c. Damage to absorptive cells
d. Na+ 90meq, K+ 20meq; Cl- 75meq; Glucose d. All of the above
111mmol e. None of the above
e. None of the above 15. Abdominal distention associated with paralytic ileus
6. A patient’s serum Na+ = 130meq/L, his serum found in diarrhea is often due to:
osmolality will be approximately a. Hyponatremia
a. 280 mosm/L b. Hypokalemia
b. 260 mosm/L c. Hypocalcemia
c. 290 mosm/L d. Hypomagnesia
d. 270 mosm/L e. None
e. None of the above 16. The effective management of acute diarrhea includes
7. Intravenous Therapy may be justifiably used in the the following, EXCEPT:
treatment of non-severe dehydration if any of the a. The gradual reintroduction of food beginning
following condition is present, EXCEPT: with clear fluids at 24-48hrs
a. High purging rate b. Fluid and electrolytre replacement
b. Inability to drink c. Give instruction when to follow up
c. Abdominal distention d. Measles immunization
d. Lactose malabsorption e. None of the above
8. When fluid shift from the ICF to the ECF 17. A 1 y/o girl was brought to you because of the tonic-
compartment, the most likely type of dehydration is: clonic seizure for 3mins at home. The day before she
a. Isotonic passed out voluminous watery stools. A few hours
b. Hypotonic before concentration, she developed high grade fever.
c. Hypertonic Physical exam revealed a lethargic infant with dry
d. None lips, skin pinch goes back very slowly. Temperature
 40c, weight 10 kg. Which of the following is the 26. In DKA pt, Na+ obtained is 130mEq/L and serum
LEAST LIKELY cause of the seizure? glucose is 500mg/dL. Compute for corrected Na.
a. Hypoglycemia a. 135
b. Benign febrile convulsion b. 136
c. Acute bacterial meningitis c. 137
d. Hyponatremia d. 138
e. Hypernatremia e. None
18. The preferred fluid to administer initially in the case 27. Non-intestinal infections are often seen in:
above: a. Acute watery diarrhea
a. Oresol b. Persistent Diarrhea
b. D5LR c. Dysentery
c. Lactated Ringers d. A&B only
d. Normal Saline e. All
e. None 28. Shifting to IV hydration in the management of
19. Recommended rate of administration of fluid in diarrhea with some dehydrarion is recommended in
number 17: the presence of the following:
a. 750cc Oresol/4hrs a. Persistent vomiting
b. D5LR 300cc/1st hr b. High purging rate
c. LR 300cc/1st hr c. Abdominal distention
d. NSS 200cc/1st hr d. A&B only
20. A simple salt- sugar mixture serves as oral e. All
rehydration fluid is prepared as follows: 29. Most profound ease in severe dehydration:
a. 1/3 tsp salt 3tsp sugar in 1000ml water a. Isotonic
b. ½ tsp salt 6tsp sugar in 1000ml water b. Hypotonic
c. 1/3 tsp salt tsp sugar in 1000ml water c. Hypertonic
d. 1/3 tsp salt 3tsp sugar in 1000ml water 30. Physiologic acidosis in the newborn is due to:
21. Your first priority when a child is brought to you a. Lower serum bicarbonate
because of loose stools and vomiting is to: b. Lower serum potassium
a. Take down history of present illness c. Lower serum chloride
b. ‘Assess the degree of dehydration d. A&B
c. Insert an IV line e. None
d. A&B 31. Neurological complication is most common in:
e. None a. Isotonic
22. Recommended drug for Amoebic dysentery? b. Hypotonic
a. Metronidazole c. Hypertonic
b. Ceftriaxone d. None
c. Ampicillin 32. Neonates larger total body water (TBW) is mainly
d. Tetracycline due to:
e. A&C a. Expanded ECF
23. The presence of this element in oral hydration b. Expanded ICF
solution promote reabsorption of salt and water: c. Greater Transcellular water
a. Sodium d. All
b. Potassium e. None
c. Glucose 33. Patient’s serum Na+ = 120 mEq/L has serum
d. Chloride osmolality approxiamately
e. Water a. 250
24. Feature/s of hypertonic dehydration b. 260
a. Hypersalivation c. 270
b. Thready pulse d. None
c. Meningismus 34. Most profound state of shock is seen most frequently
d. A&B in:
e. All a. No dehydration
25. Based on the WHO recommendation, which b. Some dehydration
treatment plan is appropriate for an irritable 2-year c. Severe dehydration
old with loose stools for five episodes, skin pinch d. All of the above
goes slowly and sunken eyeballs: 35. A 14kg patient, 4 year old, sunken eyeball, dry
a. Treatment A Plan mucosa, skin turgor goes back slowly
b. Treatment B Plan a. Some DHN
c. Treatment C Plan b. Severe DHN
d. Data not sufficient for assessment c. No DHN
36. Electrolyte imbalance seen in ileus:
a. Hyponatremia
b. Hypokalemia
c. Hypocalcemia
d. Hypomagnesemia
37. Death in acute diarrhea in infants and small children
is often most due to:
a. Dehydration
b. Severe metabolic acidosis
c. Malnutrition
d. Aspiration Pneumonia
e. Acute Renal Failure
38. According to the 2005 WHO recommendation, DOC
for shigella?
a. Ciprofloxacin
b. Ampicillin
c. Pivmecillinam
d. Ceftriaxone
e. All
39. The most acceptable solution for oral rehydration of
infants with diarrhea with some dehydration
presumably by e.coli has he composition of:
Na 75meq; K 20 meq; Cl 65meq; Glucose 75mmol
40. The following factors predispose host individuals to
be more susceptible to diarrheal disorder, EXCEPT:
a. Malnutrition
b. Increased intestinal motility
c. Reduced gastric acidity
d. Immunodeficiency
e. None