Body Fluids MCQs
These questions incorporate elements from the section on the level of water in the body
and its distribution covered at the beginning of FM1001 and from the blood section of
FM1002, with some clinical questions included when relevant.
1.Extracellular Fluid differs from intracellular fluid in that:
It has a greater volume
It has a lower tonicity
Its anions are mainly inorganic
It has a higher sodium:potassium molar ratio
Its pH is lower
2.Blood group antigens (agglutiogens) are:
Attached to the haemoglobin molecule
Simple proteins
All of similar immunogenicity
Inherited characteristics carried by the X chromosome
Inherited as recessive characteristics
3.Total body water:
Forms a smaller percentage of body weight in fat persons than in thin
Can be measured by an indicator dilution technique using deuterium oxide as
the indicator
Comprises half to two thirds of body weight in young adults
Is a smaller proportion of body weight in men than in women
Falls during starvation as a percentage of body weight
4.The breakdown of erythrocytes in the body yields:
Iron, most of which is excreted in the urine
The pigment bilirubin which is water soluble
The pigment bilirubin which is conjugated in the liver
Amino acids which are available for general use
Bile Salts such as sodium taurocholate
5.A person with group B blood:
Has ant-B antibody in the plasma
May have the genotype AB
May have a parent with group O blood
May have children with only B or O group blood
Whose partner is also B must have children of group B or O
6.Blood platelets are important in stopping bleeding in that:
They release chemicals which have a role in the clotting process
They become sticky and adhere on exposure to collagen
They are an important source of calcium for the clotting process
The bleeding time is increased when the platelet count is low
They break down to release a vasoconstrictor substance at the site of
haemorrhage
7.Bilirubin
Is a steroid pigment
Travels from red cell breakdown sites to the liver in the plasma
Contains iron
Is present in bile in a conjugated state
Promotes the normal digestion and absorption of fat
8. Monocytes
Originate from precursor cells in lymph nodes
Are phagocytic
Migrate from the blood into the tissues
Can transform into tissue macrophages
Manufacture immunoglobin M
9.Erythrocytes
Are responsible for the major part of blood viscosity
Contain the enzyme carbonic anhydrase
Increase their volume in hypertonic saline
Burst when mixed with 0.9% (150mmol/litre) saline
Do not require energy for metabolic activities
10. Neutrophil granulocytes
Are the commonest leucocytes in normal blood
Contain lysosomes with digestive enzymes
Are confined to the circulation
Contain actin and myosin filaments
Are present in high concentrations in pus
11.Bleeding from a small cut in the skin
Is normally diminished by local vascular spasm
Ceases within about five minutes in normal people
Will be prolonged if there is a severe deficiency of factor VIII
Is greater from warm skin than from cold skin
Is greater from a dependent than from an elevated arm
12. Circulating Red Blood Cells
Include about 1% which retain their nuclei
May show a network pattern when appropriately stained
Are distributed evenly in the blood stream
Travel more slowly through venules than capillaries
Are deformed as they pass through the capillaries
13.Lymphocytes
Constitute 1-2% of circulating white cells
Are motile
Can transform into plasma cells
Decrease markedly in number with removal of the adult thymus
Are decreased in number by immunosuppressive drugs
14. Blood
Comprises about 7% of body weight
Comprises a higher percentage of body weight in fat people than in thin
people
Volume can be calculated by multiplying plasma volume by haemoglobin
concentration
Volume rises when water is drunk
Which has clotted releases serum
15.Human Cell Membranes
Are impermeable to fat soluble substances
Are more permeable to sodium than to potassium
In skeletal muscle have their permeability to glucose altered in the presence
of insulin
In skeletal muscle have their permeability to potassium decreased in the
presence of insulin
Contain lipid and proteins only
16. Lymph
Contains plasma proteins
Vessels are important in the absorption of protein from the intestine
Production in muscle increases during muscular activity
Is cell free
Flow depends critically on the contraction of adjacent skeletal muscles
17.Blood platelets
Are formed in the bone marrow
Increase in number after injury and surgery
Have a small single lobed nucleus
Alter shape when in contact with collagen
Are normally more numerous than white blood cells
18.An appropriate dilution indicator for measuring
Total body water would be sucrose
Plasma volume would be radioactive sodium
Extracellular volume would be insulin
Intracellular volume would be heavy water (deuterium oxide)
Total body potassium would be radioactive potassium
19.Transfusion of blood
Of group A to a group B person causes a severe reaction
Of group O to a group AB person causes a severe reaction
Of group A to a group O person causes a severe reaction
Of group A to a group AB person causes a severe reaction
Which is rhesus negative to a rhesus positive person causes a severe
reaction
20. Rhesus disease of the newborn
Is due to breakdown of the infant’s red cells
Causes a yellow appearance (jaundice) in the infant
Occurs in infants of a rhesus positive mother
Occurs in rhesus negative infants
Can be prevented by giving D antigen to appropriate women immediately
after delivery of abortion
21. The rate of red cell formation is increased
By Vitamin B12 injections to healthy people on a normal diet
A week after a blood donation
In someone suffering from anaemia due to excess haemolysis
By erythropoietin in someone without kidneys
When the blood reticulocyte count is raised
22. Vitamin B12 deficiency
Leads to anaemia with small pale red cells
May result from wasting (atrophy) of the gastric mucosa
May result from disease of the terminal part of the ileum
May lead to a reduction in the circulating platelet level
May lead to impaired function in the nervous system
23. A raised level of calcium in the blood (hypercalcaemia)
Causes increased excitability of nerve and muscle
Is caused by chronic renal failure
Increases the risk of stone formation in the urinary tract
Is a consequence of decreased parathyroid activity
Is a consequence of a reduction in the plasma protein level
ANSWERS
F- Cells contain half to two thirds of body water therefore ICF > ECF
F- If this were true, water would be drawn by osmosis into the cells. In
reality the intracellular substances produce enough osmotic pressure to
balance the Hb, potassium ions etc of the ECF and thus the two are equal
T- Organic anions are products of metabolism, produced inside the cell
(proteins and organic phosphates), outside the cell it is mostly Chloride and
Bicarbonate
T- The concentration of [Na ions] in the ECF is 142mEq/l and [K ions] is
4mEq/l giving a ratio of over 30 to 1. The ICF ratio is 1:14 in the other
direction
F- Intracellular pH is lower due to metabolism
F- They are part of the red cell membrane (the Hb molecule is located inside
this again)
F- They are glycoproteins
F- A,B and D are more immunogenic than the others
F- They are carried by autosomes (Chromosomes are all autosomes except
for the sex determining pair referred to as the X or Y chromosome)
F-They are mendelian dominant
T- Fat contains relatively little water compared with other tissues
T- Deuterium oxide (aka heavy water) can be used
T- A percentage which falls with age
F- Women have more fat and thus less water on average than men
F- It rises as the fat stores are metabolized
F- Most iron is retained for further use
F-It is bound to circulating plasma proteins
T-It is conjugated to form bilirubin glucuronide which is water soluble and
excreted in the urine
T- The AAs come from the globin part of the Hb molecule
F-Bile Salts are formed in the liver
F- Antibody B in the plasma would then cause agglutination (agglutinins
attach to the walls of the red cells and cause masses of RBCs to accumulate)
F- This would give blood group AB
T- Then they would have inherited the O from one parent and B from the
other to give the genotype BO which is the same as B
F- A or AB are possible depending on the partner’s genes
T- There is no group A gene in either parent
T- including Thromboplastin
T- Forming Platelet Plugs
F- Calcium is found abundantly in plasma
T- As platelet plugging is impaired
T- This is known as Serotonin
F- It is a porphyrin pigment derived from Haem
T- The water insoluble bilirubin forms a water soluble complex with plasma
protein
F- Iron is removed from haem in the formation of bilirubin
T- It is conjugated with glucuronide
F- Bile salts not bile pigments are needed for this
F- They originate from precursor cells in bone marrow
T- They ingest dead granulocytes
T- Here they ingest dead granulocytes
T- These are important scavenger cells
F-Immunoglobins made by lymphocytes
T- Blood viscosity rises exponentially with the haematocrit
T- This catalyzes the formation of bicarbonate from water and carbon
dioxide
F- Osmosis causes water to leave the cells and they shrink
F- This is isotonic with their contents
F- They use energy generated from glycolysis to maintain electrochemical
gradients across their membranes
T-They comprise 60-70% of circulating leucocytes
T- The granules contain enzymes which digest the bacteria
F- They leave capillaries by the process of diapedesis
T- This may be related to their motility
T- Pus consists largely of dead neutrophils
T-Vascular smooth muscle contracts in response to local damage and release
of serotonin from adherent platelets
T- This is the upper limit of the normal ‘bleeding time’
F- Bleeding time is independent of clotting time (which would be prolonged in
this case)
T- Warmth dilates blood vessels in the skin
T- Due to the greater intravascular pressure in the dependent limb
F- Nucleated red cells are not normally seen in the blood
T- Reticulocytes are the most immature circulating form
F- They form an axial stream away from the vessel wall
F- Capillaries have a greater total cross-sectional area
T- Normal cells are around 7 microns in diameter become bullet shaped as
they pass through 5 micron diameter vessels
F- They constitute 20-40%
T- They move to areas of chronic inflammation
T- It is in this form that they produce antibodies
F- The thymus has little function in the adult
T- Lymphocytes and immune responses are closely linked
T- For example 5 kg in a 70kg man
F- The reverse is true since fat tissue has a poor blood supply
F- It can be calculated by multiplying plasma volume by 1/ (1-haematocrit) as
a decimal
T- The water is absorbed into the blood
T- Serum equals plasma minus clotting factors
F- The membrane consists largely of lipid
F- The reverse is true
T- Insulin increases permeability to glucose so that it is stored as muscle
glycogen after a meal
F- It is increased insulin is an anabolic hormone which builds up tissues with
potassium and amino acids
F- Carbohydrates are present eg blood group antigens
T- It returns these to the blood
F- They are involved in the absorption of fat
T- Increased capillary pressure leads to increased formation of tissue fluid
F- It contains lymphocytes formed in lymph nodes
F- Lymphatic vessels have their own propulsive smooth muscle activity
T- They are formed from megakaryocytes
T- This increases the tendency of blood to clot
F- They have no nucleus
T- They put out pseudopodia and adhere to the collagen and to one another
T- By a factor of 20 or more
F- Sucrose would not cross the cell membrane freely
F- The sodium ions would rapidly leave the plasma
T- insulin crosses capillary walls freely but does not enter cells (these
properties also make it appropriate for measuring the glomerular filtration
rate)
F- Intracellular volume cannot be measured directly heavy water measures
total body water
T- As with heavy water, the different isotopes are not distinguished in the
body
T- The recipient will have anti-A antibody
F- Group O people are universal donors
T- The recipient will have anti-A antibody
F- Group AB persons are universal recipients having neither anti-A or anti-B
antibodies
F- The recipient will not have anti-rhesus antibodies
T- This causes anaemia and a raised bilirubin level
T- The immature liver is slow to excrete the large amounts of bilirubin
produced
F- Only Rh- negative people produce anti-Rh antibodies
F- The Rh antibodies attack only Rh- positive red cells
F- Anti- D antibody should be given as it reacts with fetal red cells in the
mother’s circulation and prevents sensitization
F- Such people have no shortage of vitamin B12
T- The red cell defecit is being corrected
T-The lysed cells are being replaced
T- By stimulating marrow erythropoiesis
T- This confirms increased bone marrow activity
F- The cells are large and well filled with haemoglobin anaemia is due to
impaired cellular multiplication
T- Gastric mucosa produces the intrinsic factor required for B12 absorption
T- The B12 + intrinsic factor complex is absorbed here
T- B12 is used in DNA synthesis which is required by all multiplying cells
T- Maintenance of myelin also depends on vitamin B12
F- It depresses excitability
F- Phosphate retention raises blood phosphate levels, calcium must fall to
maintain a constant product
T- More calcium is filtered and increases the urinary calcium phosphate
solubility product
F- This leads to a reduced calcium level
F This lowers the bound an hence the total calcium level