病理生理学试题库-2水电解质代谢障碍.doc

<p>(完整word版)病理生理学试题库-2水电解质代谢障碍(张玉平)
第三章 水电解质代谢障碍
一. 选择题

(一).A型题： &nbsp;

1. 细胞外液中的阳离子主要是
A. Na+
B. &nbsp; K+
C. &nbsp; Ca2+
D. Mg2+
E. &nbsp; Fe2+
[答案] A
2. 细胞外液中的主要阴离子是
A． HCO3-
B． SO42-
C． CL-
D． HPO42-
E． 蛋白质
[答案] C
3. 细胞内液中的主要阳离子是
A． Na+
B． Mg2+
C． Ca2+
D． K+ &nbsp;
E． Fe2+
[答案] D
4. 细胞内液中的主要阴离子是
A．HPO42-和蛋白质
B．有机酸
C．HCO3-
D．CL-
E．SO42-
[答案] A
5. 血浆和组织间液的渗透压90~95%来源于
A．K+和HCO3-
B．Na+、CL-和HCO3-
C．Ca2+和HPO42-
D．葡萄糖和尿素
E．氨基酸和蛋白质
[答案] B
6. 维持细胞内液渗透压的离子最主要的是
A．K+ &nbsp;
B．Na+
C．Mg2+
D．Ca2+
E．HPO42-
[答案] A
7. 机体排出水分的途径有
A． 消化道
B． 皮肤
C． 肺
D． 肾
E． 以上都是
[答案] E
8. 正常成人每天至少必须排出多少尿液才能清除体内的代谢废物？
A． 800ml
B． 1000ml
C． 500ml
D． 1200ml
E． 1500ml
[答案] C
.９.心房利钠肽释放入血后，主要通过哪条途径影响水钠代谢？
A． 减少肾素的分泌
B． 抑制醛固酮的分泌
C． 对抗血管紧张素的缩血管效应
D． 拮抗醛固酮的滞Na+作用
E． 以上都是
[答案] E
10.低渗性脱水的特点是
A． 失Na+多于失水
B． 血清Na+浓度〈130mmol/L
C． 血浆渗透压〈280mmol/L
D． 伴有细胞外液量减少
E． 以上都是
[答案] E
11.低容量性低钠血症也可称为
A． 高渗性脱水
B． 等渗性脱水
C． 低渗性脱水
D． 原发性脱水
E． 水中毒
[答案] C
12.下列哪项不是引起低容量性低钠血症的原因？
A． 长期持续使用速尿或利尿酸
B． .肾上腺皮质功能亢进 &nbsp;
C． 慢性间质性肾疾患
D． 消化道失液（呕吐,腹泻）
E． 大量出汗和大面积烧伤
[答案] B
13.下列低容量性低钠血症对机体的影响,哪项是不正确的?
A． 细胞外液减少,易发生休克 &nbsp; &nbsp; &nbsp;
B． 无口渴感 &nbsp; &nbsp;
C． 早期便有ADH分泌增多，晚期ADH分泌减少
D． 有明显失水体征
E． 肾外因素所致失钠者,尿Na+含量减少
[答案] C
14.处理低容量性低钠血症,原则上给予
A. 生理盐水 &nbsp; &nbsp;
B. &nbsp;5%的葡萄糖液
C. &nbsp;血浆
D. 糖酐
E. &nbsp;7.5%Nacl
[答案] A
15.高容量性低钠血症的特点是
A．血清Na+浓度〈130mmol/L
A． 血浆渗透压〈280mmol/L
B． 体钠总量正常或增多
C． 体液量明显增多
D． 以上都是
[答案] E
16.高容量性低钠血症也可称为
A． 水中毒
B． 低渗性脱水
C． 等渗性脱水
D． 高渗性脱水
E． 原发性脱水
[答案] A
17.高容量性低钠血症最常发生于
A． 用无盐水灌肠
B． 急性肾功能不全患者而又补液不恰当时
C． 精神性饮水
D． 持续大量饮水
E． ADH分泌过多
[答案] B
18.下列高容量性低钠血症对机体的影响,哪项是不正确的?
A． 细胞外液量增多，血液稀释 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;
B． 细胞内水肿 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;
C． 无中枢神经系统症状
D． 红细胞压积降低
E． 早期尿量增加（肾功能障碍者例外），尿比重下降
[答案] C
19.下列关于低容量性高钠血症的叙述,哪项是错误的?
A． 失水〉失钠 ，血清Na+浓度〉150mmol/L
B． 血浆渗透压&gt;310 mmol/L
C． 细胞外液量和细胞内液量均减少
D． 细胞外液量减少，细胞内液量维持不变
E． 又称为高渗性脱水
[答案] D
20.尿崩症患者易引起
A． 低渗性脱水
B． 高渗性脱水
C． 等渗性脱水
D． 水中毒
E． 盐中毒
[答案] B
21.下列关于低容量性高钠血症对机体的影响,哪项是不正确的?
A． 口渴
B． 细胞内液向细胞外液转移 &nbsp; &nbsp; &nbsp;
C． 细胞外液容量增加
D． 尿少,尿比重增加
E． 醛固酮和ADH分泌增加
[答案] C
22.下列关于高容量性高钠血症的叙述，哪项是错误的?
A． 血容量和血钠均增多
B． 其主要原因是盐摄入过多或盐中毒
C． 细胞外液向细胞内转移
D． 严重者引起中枢神经系统功能障碍
E． 对肾功能正常的患者可用速尿治疗
[答案] C
23.等容量性高钠血症的发生机制是
A． 渗透压调定点下移
B． 渗透压感受器阈值升高
C． 摄入钠过多
D． 钠排出过少
E． Cushing综合征
[答案] B
24.低渗性脱水时机体表现为 &nbsp;
&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;细胞内液 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; 细胞外液
A. &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;↓ &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;↓↓
B. &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; ↓↓ &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;↓
C. &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; ↓↓ &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; ↓↓
D. &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; ↑ &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; ↓↓
E. &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; ↓↓ &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;正常 &nbsp;
[答案] D
25.高渗性脱水时机体表现为 &nbsp;
&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;细胞内液 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;细胞外液
A. &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; ↓ &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; ↑↑
B. &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; ↓↓ &nbsp; &nbsp; &nbsp; &nbsp; . &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;↓
C. &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;↓ &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;正常
D. &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; ↑↑ &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;↓↓
E. &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; 正常 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; ↓
[答案] B
26.等渗性脱水时机体表现为 &nbsp;
&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;细胞内液 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;细胞外液
A. &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; ↓ &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; ↓
B. &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; ↓ &nbsp; &nbsp; &nbsp; &nbsp;. &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; ↑
C. &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; ↓ &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;变化不大 &nbsp;
D. &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; ↑ &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; ↓ &nbsp;
E. &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;变化不大 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; ↓
[答案] E
27.哪一类水、钠代谢障碍更易发生休克?
A． 低渗性脱水 &nbsp; &nbsp; &nbsp;
B． 等渗性脱水 &nbsp; &nbsp; &nbsp;
C． 高渗性脱水 &nbsp; &nbsp; &nbsp;
D． 水中毒
E． 原发性高钠血症
[答案] A
28.水肿是指
A． 细胞内液过多
B． 细胞外液过多
C． 组织间隙或体腔内液体过多
D． 血管内液体过多
E． 体内液体过多
[答案].C
29．下列血管内外液体交换平衡失调的发生机制哪项是不正确的？
A． 毛细血管流体静压增高
B． 血浆晶体渗透压增高
C． 微血管壁通透性增加
D． 血浆胶体渗透压降低
E． 淋巴回流受阻
[答案].B
30.引起血浆胶体渗透压降低的常见病因是
A． 肝硬变
B． 严重营养不良
C． 肾病综合征
D． 恶性肿瘤
E． 以上都是
[答案].E
31.造成体内外液体交换平衡失调——钠、水潴留的机制哪项是不正确的？
A． GFR降低
B． 心房肽分泌减少
C． 肾小球滤过分数降低
D． 醛固酮分泌增多
E． ADH分泌增多
[答案].C
32.下列影响钾跨细胞转移因素的叙述哪项是不正确的？
A． 胰岛素直接刺激Na+-K+-ATP酶的活性，促细胞摄钾
B． β-肾上腺能的激活通过cAMP机制激活Na+-K+-ATP酶，促细胞摄钾
C． 酸中毒促进钾离子移出细胞，而碱中毒作用正好相反
D． 细胞外液钾离子浓度升高可直接抑制Na+-K+-ATP酶的活动
E． 细胞外液渗透压的急性升高促进钾离子自细胞内移出
[答案].D
33.影响远曲小管、集合管排钾的调节因素是
A． 醛固酮
B． 细胞外液的钾浓度
C． 远曲小管的原尿流速
D． 酸碱平衡状态
E． 以上都是
[答案].E
34.引起缺钾和低钾血症的最主要原因是
A． 钾丢失过多 &nbsp;
B． 碱中毒 &nbsp; &nbsp; &nbsp;
C． 长期使用β受体激动剂 &nbsp; &nbsp; &nbsp;
D． 钾摄入不足 &nbsp; &nbsp;
E． 低钾性周期性麻痹
[答案].A
35.经肾失钾过多的原因是
A． 速尿、利尿酸的使用
B． 肾小管性酸中毒
C． 盐皮质激素过多
D． 镁缺失
E． 以上都是
[答案].E
36.下面关于肾外途径过度失钾的原因，哪一项是不正确的？
A． 呕吐、腹泻
B． 胃肠减压
C． 钡中毒
D． 肠瘘
E． 过量发汗
[答案].C
37.使用外源性胰岛素产生低钾血症的机制是
A． 醛固酮分泌增多 &nbsp; &nbsp; &nbsp; &nbsp;
B． 跨细胞转移，细胞摄钾增多
C． 肾小管重吸收钾障碍
D． 结肠上皮细胞分泌钾过多
E． &nbsp;呕吐、腹泻致失钾过多
[答案].B
38.急性低钾血症对神经肌肉组织膜电位的影响是
&nbsp; 静息电位(负值) &nbsp; &nbsp;阈电位（负值） &nbsp; 静息电位与阈电位间差距
A. &nbsp; &nbsp; &nbsp;不变 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; ↑ &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; ↑
B. &nbsp; &nbsp; &nbsp;不变 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; ↓ &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; ↓
C. &nbsp; &nbsp; &nbsp; ↑ &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;↑ &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; ↑
D. &nbsp; &nbsp; &nbsp; ↑ &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;不变 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; ↑
E. &nbsp; &nbsp; &nbsp; ↓ &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;不变 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; ↓
[答案].D
39.急性低钾血症对心肌膜电位的影响是
&nbsp;静息电位(负值) &nbsp; &nbsp; 阈电位（负值） &nbsp; &nbsp;静息电位与阈电位间差距
A. &nbsp; &nbsp; &nbsp;↓ &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; 不变 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; ↓
B. &nbsp; &nbsp; &nbsp;↓ &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;↓ &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; 不变
C. &nbsp; &nbsp; &nbsp;↓ &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;↑ &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;↓
D. &nbsp; &nbsp; &nbsp;↑ &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; 不变 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; ↑
E. &nbsp; &nbsp; &nbsp;↑ &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;↑ &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;↑
[答案].A
40.急性低钾血症对心肌生理特性的影响是 &nbsp;
&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;兴奋性 &nbsp; &nbsp; &nbsp; &nbsp; 传导性 &nbsp; &nbsp; &nbsp; &nbsp; 自律性 &nbsp; &nbsp; &nbsp; &nbsp;收缩性
&nbsp;A. &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; ↓ &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;↓ &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; ↑ &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; ↑
&nbsp;B. &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; ↑ &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;↓ &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; ↑ &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; ↑
&nbsp;C. &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; ↑ &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;↑ &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; ↑ &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; ↑
&nbsp;D. &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; ↓ &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;↑ &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; ↓ &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; ↑
&nbsp;E. &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; ↓ &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;↓ &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; ↓ &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; ↓
[答案].B
41.低钾血症的心电图特点是
&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; QRS波 &nbsp; &nbsp; &nbsp; &nbsp;ST段 &nbsp; &nbsp; &nbsp; &nbsp; T波 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;u波 &nbsp;
&nbsp;A. &nbsp; &nbsp; &nbsp; &nbsp; 增宽 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;下移 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;低平 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; 有
&nbsp;B. &nbsp; &nbsp; &nbsp; &nbsp; 增宽 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;正常 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;低平 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; 无
&nbsp;C. &nbsp; &nbsp; &nbsp; &nbsp; 增宽 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;上移 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;高尖 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; 无 &nbsp;
&nbsp;D. &nbsp; &nbsp; &nbsp; &nbsp; 变窄 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;下移 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;高尖 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; 无
&nbsp;E. &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;变窄 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;正常 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;正常 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; 有
[答案].A
42.低钾血症对心肌功能的损害可表现有
A． 窦性心动过速
B． 期前收缩
C． 阵发性心动过速
D． 对洋地黄类药物毒性的敏感性增高
E． 以上都是
[答案].E
43.引起高钾血症最重要的原因是
A． 酸中毒
B． 使用β受体阻滞剂
C． 洋地黄中毒
D． 肾排钾障碍
E． 摄钾过多
[答案].D.
44..高钾血症对心肌生理特性的影响是 &nbsp;
&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;兴奋性 &nbsp; &nbsp; &nbsp; &nbsp; 传导性 &nbsp; &nbsp; &nbsp; &nbsp; 自律性 &nbsp; &nbsp; &nbsp; &nbsp;收缩性
&nbsp;A. &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; ↑ &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;↑ &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; ↑ &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; ↑
&nbsp;B. &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; ↑ &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;↓ &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; ↑ &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; ↑
&nbsp;C. &nbsp; &nbsp; &nbsp; &nbsp; 先↑后↓ &nbsp; &nbsp; &nbsp; &nbsp;↓ &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; ↓ &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; ↓
&nbsp;D. &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; ↓ &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;↑ &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; ↓ &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; ↓
&nbsp;E. &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; ↓ &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;↑ &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; ↓ &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; ↑
[答案].C
45.高钾血症的心电图特点是
&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; QRS波 &nbsp; &nbsp; &nbsp; &nbsp;P—R间期 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;T波 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;
&nbsp;A. &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;增宽 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;延长 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;高尖 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;
&nbsp;B. &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;增宽 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;缩短 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;正常 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;
&nbsp;C. &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;变窄 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;正常 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;高尖 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;
&nbsp;D. &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;变窄 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;缩短 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;低平 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;
&nbsp;E. &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;正常 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;延长 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;低平 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;
[答案].A
46.在下列引起低镁血症的原因中,哪项是不正确的?
A． 严重腹泻 &nbsp; &nbsp;
B． 醛固酮分泌减少
C． 高钙血症 &nbsp; &nbsp;
D． 甲状旁腺功能低下 &nbsp; &nbsp;
E． 糖尿病酮症酸中毒
[答案].B
47.低镁血症对机体的影响有哪项是不正确的？
A． 神经肌肉的应激性增强
B． 可引起多种神经、精神症状
C． 可引起心律失常
D． 可拮抗儿茶酚胺和内皮素等的缩血管作用
E． 可致低钙血症和低钾血症
[答案] D
48.低镁血症对心肌生理特性的影响是
&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;兴奋性 &nbsp; &nbsp; &nbsp; &nbsp;传导性 &nbsp; &nbsp; &nbsp; &nbsp;自律性 &nbsp; &nbsp; &nbsp; &nbsp;收缩性
&nbsp;A. &nbsp; &nbsp; &nbsp; &nbsp;↓ &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;↓ &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; ↓ &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; ↓
&nbsp;B. &nbsp; &nbsp; &nbsp; &nbsp;↓ &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;↓ &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; ↑ &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; ↑
&nbsp;C. &nbsp; &nbsp; &nbsp; &nbsp;↑ &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;↓ &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; ↑ &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; ↑
&nbsp;D. &nbsp; &nbsp; &nbsp; &nbsp;↑ &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;↑ &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;↑ &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; ↑
&nbsp;E. &nbsp; &nbsp; &nbsp; &nbsp;↓ &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;↑ &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; ↓ &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; ↓
[答案] C
49 .产生高镁血症最重要的原因是
A． 肾脏排镁障碍 &nbsp; &nbsp;
B． 摄镁过多.
C． PTH分泌增多
D． 醛固酮分泌增多症
E． 饮食中钙含量增加
[答案] A
50.肾排镁障碍致高镁血症的常见病因是
A． 急性肾功能衰竭少尿期
B． 严重低渗性脱水
C． 甲状腺功能减退
D． Addison病
E． 以上都是
[答案] E
51.急性高镁血症的紧急治疗措施是
A． 改善肾功能
B． 静注钙制剂
C． 治疗原发病
D． 纠正酸中毒
E． 静脉输注生理盐水
[答案] B
52.下面哪项不是引起低钙血症的病因？
A． 肝硬化 &nbsp; &nbsp;
B． 慢性肾功能衰竭 &nbsp; &nbsp;
C． 高镁血症
D． 甲状旁腺功能减退
E． 急性胰腺炎 &nbsp;
[答案] C
53.慢性肾功能衰竭患者产生低血钙的机制是
A． 血磷升高
B． VitD羟化障碍
C． 骨抗PTH
D． 肠钙吸收障碍
E． 以上都是
[答案] E
54.低钙血症对机体的影响哪一项不存在？
A． 神经肌肉兴奋性增高
B． 心肌兴奋性、传导性升高
C． 骨质钙化障碍
D． 心肌收缩性增强
E． 婴幼儿免疫力低下
[答案] D
55.下列哪项不是高钙血症的病因？
A． 原发性甲状旁腺功能亢进
B． 慢性肾功能衰竭
C． 恶性肿瘤
D． VitD中毒
E． 肾上腺皮质功能减退
[答案] B
56.下列高钙血症对机体的影响哪项是不正确的？
A． 神经肌肉兴奋性下降
B． 主要损害肾小管
C． 心肌兴奋性、传导性均升高
D． 异位钙化
E． 严重高血钙可产生高血钙症危象
[答案]C
57.血磷通常是指
A． 血浆中的无机磷
B． 红细胞中所含的磷
C． 血浆磷脂中所含的磷
D． 血浆中磷脂及无机磷酸盐所含磷的总和
E． 红细胞和血浆磷脂中所含磷的总和
[答案] A
58.引起低磷血症的原因是
A． 长期使用利尿剂
B． VitD缺乏
C． 呼吸性碱中毒
D． 甲状旁腺功能亢进
E． 以上都是
[答案] E
59.在引起高磷血症的病因中，下列哪一项是不正确的？
A． 肾功能衰竭
B． VitD中毒
C． 甲状旁腺功能亢进
D． 急性酸中毒
E． 淋巴性白血病
[答案] C
60.高磷血症对机体的影响中哪一项不存在？
A． 低钙血症
B． 异位钙化
C． 抑制肾1α羟化酶
D． 低镁血症
E． 抑制骨的重吸收
[答案] D

B型题
A． 低渗性脱水
B． 高渗性脱水
C． 等渗性脱水
D． 水中毒
E． 水肿
61.低容量性低钠血症又称为
62.高容量性低钠血症又称为
63.低容量性高钠血症又称为
[答案] &nbsp;61.A &nbsp;62.D &nbsp;63.B

A． 低渗性脱水
B． 等渗性脱水
C． 高渗性脱水
D． 等容量性低钠血症
E． 等容量性高钠血症
64.尿崩症病人易出现
65.大面积烧伤病人易出现
66.大汗者大量饮水易出现
67.SIADH病人易出现
68.下丘脑受损患者易出现
[答案] &nbsp;64.C &nbsp;65.B &nbsp;66.A &nbsp;67.D &nbsp;68.E

A． 补充等渗液
B． 补水为主，适当补钠
C． 补偏低渗（1/2或2/3张）液
D． 补充水分以降低血钠
E． 限制水分摄入，对重症或急性患者，还应给予高渗盐水
69.高渗性脱水的补液原则是
70.等渗性脱水的补液原则是
71.低渗性脱水的补液原则是
72.水中毒的补液原则是
73.等容量性高钠血症的补液原则是
[答案] &nbsp;69.B &nbsp;70.C &nbsp;71.A &nbsp; 72.E &nbsp;73.D
A． 尿量减少，尿钠含量降低
B． 尿量减少，尿钠含量增加
C． 尿量不少，尿钠含量降低
D． 尿量增多，尿钠含量降低
E． 尿量增多，尿钠含量增加
74.肾性原因引起的低容量性低钠血症晚期
75.肾外原因引起的低容量性低钠血症早期
76.低容量性高钠血症早期
77.低容量性高钠血症晚期
78.全身性水肿
[答案] &nbsp;74.B &nbsp;75.D &nbsp;76.B &nbsp;77.A &nbsp;78.A
&nbsp;
A． 骨骼肌静息膜电位负值增大
B． 骨骼肌静息膜电位负值减少
C． 骨骼肌阈电位上移
D． 骨骼肌阈电位下移
E． 骨骼肌静息膜电位和阈电位负值均减少
79.低钾血症
80.高钾血症
[答案]79.A &nbsp;80.B
&nbsp; &nbsp; &nbsp; 心肌兴奋性 &nbsp; &nbsp;心肌传导性 &nbsp; &nbsp; 心肌自律性 &nbsp; &nbsp; &nbsp;心肌收缩性
&nbsp;A. &nbsp; &nbsp; &nbsp; ↑ &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;↓ &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; ↑ &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; ↑
&nbsp;B . &nbsp; &nbsp; &nbsp; ↓ &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;↓ &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; ↓ &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; ↓
&nbsp;C &nbsp; &nbsp; &nbsp; &nbsp;↓ &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;↑ &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; ↓ &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; ↓ &nbsp;
&nbsp;D &nbsp; &nbsp; &nbsp; &nbsp;↑ &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;↑ &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; ↑ &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; ↓
&nbsp;E &nbsp; &nbsp; &nbsp; &nbsp;↓ &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;↓ &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;↓ &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;↑ &nbsp;
81.急性低钾血症
82.严重高钾血症
83.低镁血症
84.高镁血症
[答案] 81.A &nbsp;82.B &nbsp;83.A &nbsp;84.C

C型题
A． 尿少
B． 低容量性休克
C． 两者均有
D． 两者均无
85.低渗性脱水患者可表现有
86.等渗性脱水患者可表现有
87.高渗性脱水患者可表现有
[答案] 85.C &nbsp;86.C &nbsp;87.A
A． 细胞外液容量增加
B． 细胞内液容量增加
C． 两者均有
D． 两者均无
88.水中毒
89.高渗性脱水
90.等渗性脱水
[答案] &nbsp;88.C &nbsp;89.D &nbsp;90.D

A． 细胞外液容量减少
B． 细胞内液容量减少
C． 两者均有
D． 两者均无
91.低渗性脱水
92.等渗性脱水
93.高渗性脱水
94.水中毒
[答案] 91.A &nbsp;92.A &nbsp;93.C &nbsp;94.D

A． 低钾血症
B． 低镁血症
C． 两者均有
D． 两者均无
95.胰岛素治疗糖尿病酮症酸中毒时易发生
96.长期使用速尿或利尿酸时易发生
97.Addison病患者可出现
98.急性肾功能衰竭少尿期易发生
[答案] 95.C &nbsp;96.C &nbsp;97.D &nbsp;98.D

A． 高钾血症
B． 高镁血症
C． 两者均有
D． 两者均无
99.急性肾功能衰竭少尿期易发生
100.长期使用β受体阻滞剂
101.Addison病患者可出现
102.醛固酮增多症患者可发生
[答案] 99.C &nbsp;100.A &nbsp; 101.C &nbsp; 102.D

A． 神经肌肉兴奋性降低
B． 心肌兴奋性降低
C． 两者均有
D． 两者均无
103.低钾血症时
104.严重高钾血症时
105.低镁血症时
106.高镁血症时
[答案] 103.A &nbsp;104.C &nbsp;105.D &nbsp;106.C

A． 低钙血症
B． 低磷血症
C． 两者均有
D． 两者均无
107.VitD代谢障碍
108.慢性肾功能衰竭患者可产生
109.甲状旁腺功能亢进症患者可产生
110.降钙素分泌过多可产生
[答案] 107.C &nbsp;108.A &nbsp;109.B &nbsp;110.C

X型题
111.低容量性低钠血症患者的临床表现有
A． 易发生休克
B． 无口渴感
C． 早期多尿，晚期可出现少尿
D． 皮肤弹性减退，眼窝及囟门凹陷
E． 肾性因素所致者，尿钠含量减少，肾外因素所致者，尿钠含量增多
[答案] ABCD
112.高容量性低钠血症可出现
A． 细胞外液容量增加
B． 细胞内液高渗
C． 细胞内水肿
D． 颅内高压，严重者发生脑疝
E． 血红蛋白浓度和红细胞压积降低
[答案] ACDE
113.引起低容量性高钠血症的病因是
A． 代谢性酸中毒
B． 甲状腺功能亢进
C． ADH分泌异常综合征
D． 尿崩症
E． Cushing综合征
[答案] ABD
114.低容量性高钠血症患者的临床表现有
A． 口渴
B． 尿少，尿比重增高
C． .红细胞压积增高
D． 颅内高压
E． 尿钠显著增加
[答案] ABC
115.造成血管内外液体交换平衡失调的病因是
A． 充血性心力衰竭
B． 肾病综合征
C． 丝虫病
D． 肝硬化
E． 恶性肿瘤
[答案] ABCDE
116.造成体内外液体交换平衡失调—钠、水潴留的因素是
A． GFR降低
B． 心房肽分泌增多
C． 肾小球滤过分数降低
D． ADH分泌增多
E． 醛固酮分泌增多
[答案] ADE
117.全身性水肿的分布特点与下列因素有关
A． 水肿的病因
B． 重力效应
C． 组织结构特点
D． 局部血流动力学因素
E． 水肿发生速度
[答案] BCD
118.影响钾跨细胞转移的因素是
A． 胰岛素
B． 儿茶酚胺
C． 细胞外液的钾离子浓度
D． 酸碱平衡状态
E． 细胞外液的渗透压
[答案] ABCDE
119.促进钾离子自细胞内移出的因素
A． 胰岛素
B． α受体激动剂
C． 细胞外钾离子浓度升高
D． 酸中毒
E． 运动
[答案] BDE
120.促进远曲小管、集合管排钾的因素是
A． 醛固酮分泌增加
B． 远曲小管的原尿流速增大
C． 细胞外钾浓度升高
D． 碱中毒
E． ADH分泌增加
[答案] ABCD
121.引起低钾血症的原因是
A． 长期使用β受体激动剂
B． 肾小管性酸中毒
C． 醛固酮增多症
D． 长期使用安体舒通、氨苯喋啶
E． 慢性腹泻
[答案]ABCE
122.低钾血症对心肌电生理特性的影响是
A． 兴奋性升高
B． 兴奋性先升高后降低
C． 传导性降低
D． 传导性升高
E． 自律性升高
[答案]ACE
123.低钾血症的典型心电图改变表现为
A． T波低平
B． ST段下降
C． U波增高
D． QRS波增宽
E． 心率增快和异位心律
[答案]ABCDE
124.引起高钾血症的原因是
A． 慢性肾功能衰竭早期
B． 急性肾功能衰竭少尿期
C． Addison病
D． 糖尿病酮症酸中毒
E． 长期使用β受体激动剂
[答案]BCD
125.高钾血症对心肌电生理特性的影响是
A． 兴奋性升高
B． 兴奋性先升高后降低
C． 传导性升高
D． 传导性下降
E． 自律性下降
[答案]BDE
126.高钾血症的心电图表现为
A． T波高尖
B． T波低平
C． QRS波增宽
D． P-R间期延长
E． 心律失常，严重时发生室颤
[答案]ACDE
127.为对抗高K+的心肌毒性,临床紧急处理措施是
A． 静注快速洋地黄类制剂
B． 使用安体舒通、安苯喋啶利尿
C． 静注碳酸氢钠或乳酸钠
D． 静注钙制剂
E． 透析疗法
[答案]CDE
128.引起低镁血症的病因是
A． 严重腹泻
B． 广泛小肠切除
C． 低钙血症
D． 肾上腺皮质功能不全
E． 慢性酒精中毒
[答案] ABE
129.低镁血症患者可表现有
A． 神经肌肉兴奋性增强
B． 神经精神症状
C． 室性心律失常
D． 高钙血症
E． 高钾血症
[答案] ABC
130.产生高镁血症的病因是
A． 急性肾功能衰竭多尿期
B． 严重低渗性脱水
C． Addison病
D． 甲状腺功能减退
E． 肠瘘
[答案]BCD
131.高镁血症对机体的影响是
A． 肌无力
B． 嗜睡或昏迷
C． 血压下降
D． 冠状动脉痉挛
E． 心脏传导阻滞和心动过缓
[答案] ABCE
132.引起VitD代谢障碍的病因是
A． 慢性腹泻
B． 阻塞性黄疸
C． Addison病
D． 肝硬变
E． 慢性肾功能衰竭
[答案] ABDE
133.产生低钙血症的病因是
A． 高镁血症
B． VitD缺乏
C． 甲状旁腺功能减退
D． 慢性肾功能衰竭
E． 急性胰腺炎
[答案] BCDE
134.低钙血症对机体的影响是
A． 神经肌肉兴奋性增高
B． 骨质钙化障碍
C． 心肌兴奋性、传导性降低
D． 心肌收缩力增强
E． 婴幼儿免疫功能增强
[答案] AB
135.低钙血症对心肌的影响表现为
A． 兴奋性升高
B． 传导性升高
C． 收缩力降低
D． 自律性降低
E． ECG表现为Q—T间期缩短，ST段缩短
[答案] ABC
136.高钙血症对肾的损害表现为
A． 肾小管水肿、坏死、基底膜钙化
B． 晚期肾小管纤维化，肾钙化、肾结石
C． 浓缩功能障碍
D． 肾功能衰竭
E． 对肾小球的破坏尤为突出
[答案]。ABCD
二、填空题
1.正常成人每天最低尿量为 &nbsp; &nbsp; &nbsp; &nbsp; ml,每天最低排出的水量为 &nbsp; &nbsp; &nbsp; &nbsp; ml。
[答案] 500 &nbsp;1500
2.低容量性低钠血症的特点是 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; ， &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;, &nbsp; &nbsp; &nbsp; &nbsp; 和 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;。
[答案] 失Na+多于失水 &nbsp; 血清Na+浓度〈130mmol/L &nbsp; &nbsp;血浆渗透压〈280mmol/L &nbsp; &nbsp;伴有细胞外液量减少
3.低容量性低钠血症主要表现为 &nbsp; &nbsp; &nbsp; &nbsp; 量减少，易发生 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;；其中 &nbsp; &nbsp; &nbsp; &nbsp; 量减少更为明显，故出现明显的 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;。
[答案] 细胞外液 &nbsp; 休克 &nbsp; 组织间液 &nbsp; 失水征（脱水征）
4.低容量性低钠血症的治疗，原则上应给予 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;。
[答案] 等渗液（生理盐水）
5.等容量性低钠血症主要见于 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;。
[答案] ADH分泌异常综合征（SIADH）
6.低容量性高钠血症的特点是 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;和 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;。
[答案] 失水多于失钠 &nbsp; 血清钠浓度〉150mmol/L &nbsp; 血浆渗透压〉310mmol/L &nbsp; 细胞内、外液量均减少
7.高容量性低钠血症发生的主要原因是 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;，故最易发生于 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;时。
[答案] 过多的低渗性体液在体内潴留 &nbsp; 急性肾功能不全的病人而又输液不当
8.低容量性高钠血症的补液原则是 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;。
[答案] 补水为主，适当补钠
9.水肿的发病机制主要是 &nbsp; &nbsp; &nbsp; &nbsp; 和 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;。
[答案] 血管内外液体交换平衡失调 &nbsp; &nbsp;体内外液体交换平衡失调—钠、水潴留
10.近曲小管重吸钠水增多的机制是 &nbsp; &nbsp; &nbsp; &nbsp; 和 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;。
[答案]。心房肽分泌减少 &nbsp; &nbsp;肾小球滤过分数增加
11.导致远曲小管和集合管重吸收钠水增加的机制是 &nbsp; &nbsp; &nbsp; &nbsp; 和 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;。
[答案] 醛固酮分泌增多 &nbsp; ADH分泌增多
12.机体对钾平衡的调节主要依靠两大机制，即 &nbsp; &nbsp; &nbsp; &nbsp; 和 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;。
[答案] 肾的调节 &nbsp; 钾的跨细胞转移
13.机体对快速变动的钾负荷的首要调节目标是 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;,这主要依靠 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; 来实现．
[答案]维持血浆钾浓度的恒定　　细胞内外K+的转移　　
14.影响远曲小管和集合管主细胞分泌钾的因素是 &nbsp; &nbsp; &nbsp; &nbsp; 、 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;和 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;。
[答案] 影响主细胞基底膜面的Na+—K+泵活性　　影响管腔面胞膜对K+的通透性　　改变从血液到小管腔钾的电化学梯度
15.影响远曲小管和集合管排钾的因素是 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; 、 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; 、 &nbsp; &nbsp; &nbsp; &nbsp; 和 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;。
[答案] 醛固酮 &nbsp; 细胞外液钾浓度 &nbsp; 远曲小管的原尿流速 &nbsp; 酸碱平衡状态
16.引起低钾血症的三大原因是 &nbsp; &nbsp; &nbsp;、 &nbsp; &nbsp; &nbsp; 和 &nbsp; &nbsp; &nbsp; ，其中最主要的原因是 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;。
[答案] 钾摄入不足 &nbsp; 钾丢失过多 &nbsp; 钾的跨细胞分布异常 &nbsp; 钾丢失过多
17.低钾血症和缺钾对机体的影响主要表现在三个方面，即 &nbsp; &nbsp; &nbsp; &nbsp; 、 &nbsp; &nbsp; &nbsp; &nbsp; 和 &nbsp; &nbsp; &nbsp; &nbsp; 。
[答案] 膜电位异常引发的一系列障碍 &nbsp; 细胞代谢障碍引发的损害 &nbsp; 酸碱异常
18.低钾血症对心功能损害的具体表现是 &nbsp; &nbsp; &nbsp; &nbsp; 和 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;。
[答案] 心律失常 &nbsp; 对洋地黄类强心药物毒性的敏感性增加
19.高钾血症对机体的主要影响和威胁是 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;。
[答案] 各种心律失常（特别是致死性心律失常）
20.血清镁含量低于 &nbsp; &nbsp; &nbsp; &nbsp; 称为低镁血症，高于 &nbsp; &nbsp; &nbsp; &nbsp; 称为高镁血症。
[答案] 0.75mmol/L &nbsp; &nbsp;1.25mmol/L
21.引起高镁血症的主要原因是 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;。
[答案] 肾排镁障碍
22.机体对钙、磷代谢的调节，主要由 &nbsp; &nbsp; &nbsp; &nbsp; 、 &nbsp; &nbsp; &nbsp; &nbsp; 和 &nbsp; &nbsp; &nbsp; &nbsp; 三种激素通过三个靶器官，即 &nbsp; &nbsp; &nbsp; &nbsp; 来调节。
[答案] PTH &nbsp; VitD &nbsp; 降钙素（CT） &nbsp; 肾、骨和肠
23.高钙血症对肾功能的损害，早期主要表现为 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;。
[答案] 浓缩功能障碍 &nbsp;
24.低磷血症和缺磷的主要原因是 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;。
[答案] VitD缺乏导致肠道磷吸收障碍
25.低磷血症主要引起的异常为 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;。
[答案] ATP生成不足和红细胞中2，3—DPG减少
26.高磷血症的临床表现与 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;有关．
[答案] 高磷血症诱导的低钙血症和异位钙化

三．名词解释
1.跨细胞液（transcellular fluid）
[答案] 跨细胞液是组织间液中的极少部分分布于一些密闭腔隙（关节囊、颅腔、胸腔、腹腔等）中，是由上皮细胞分泌产生的，为一特殊部分，也称第三间隙液。
1. aquaporins(AQP)
[答案] 水通道蛋白是一组广泛存在于生物界的构成水通道与水通透有关的细胞膜转运蛋白。
2. hypovolemic hyponatremia
[答案] 低容量性低钠血症又称为低渗性性脱水，其特点是失Na+多于失水，血清Na+浓度〈130
mmol/L，血浆渗透压〈280mmol</p>