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A blood lactate level above about which value is usually considered raised in an adult?

1. A10 mmol/L
2. B20 mmol/L
3. C0.2 mmol/L
4. D2 mmol/L

What is a main role of albumin in the blood?

1. AIt holds fluid in the vessels by oncotic pressure
2. BIt fights bacteria by engulfing them in the blood
3. CIt carries oxygen from the lungs to the tissues
4. DIt forms the mesh that holds a blood clot together

What does a creatinine clearance measured from a 24-hour urine collection estimate?

1. AThe concentrating ability of the urine
2. BThe amount of protein lost from the blood
3. CThe rate of red cell production
4. DThe glomerular filtration rate

Which instruction is correct for a patient taking an oral potassium chloride supplement?

1. ACrush the extended-release tablets and mix them with a little water if needed
2. BTake it with food and a full glass of water, and do not crush extended-release tablets
3. CUse a salt substitute as well, so less of the tablet is needed each day
4. DTake it on an empty stomach with only a small sip of water to speed absorption

A trauma patient receives 2 L of IV crystalloid. The hemoglobin falls from 13.0 to 11.4 g/dL (130 to 114 g/L), and the vital signs are now stable. Which explanation is most likely?

1. AIncreased red cell production
2. BA laboratory error in the first sample
3. CDilution of the blood by the IV fluid
4. DA sudden failure of the bone marrow

A patient has taken hydrochlorothiazide for several years. Which laboratory change is a recognized effect of this drug?

1. AA fall in blood glucose
2. BA fall in serum calcium
3. CA rise in serum uric acid
4. DA rise in serum potassium

A patient with schizophrenia drinks very large amounts of water each day. Sodium is 121 mEq/L, and the urine is very dilute (urine osmolality 70 mOsm/kg). Which explanation fits best?

1. ACentral diabetes insipidus
2. BPrimary (psychogenic) polydipsia
3. CSyndrome of inappropriate ADH
4. DHyperosmolar hyperglycemic state

An older adult with type 2 diabetes is drowsy and very dehydrated. Glucose 920 mg/dL (51 mmol/L), serum osmolality 350 mOsm/kg, pH 7.36, urine ketones negative or trace. Which condition fits best?

1. ASyndrome of inappropriate ADH (SIADH)
2. BHyperosmolar hyperglycemic state (HHS)
3. CMetformin-related lactic acidosis
4. DDiabetic ketoacidosis (DKA)