Table 1.

Measures of learning

Questions
Tests of retention
How did Suzie develop severe acute hyponatremia? Write down all the factors mentioned in the case that could have contributed.
Describe the major body fluid compartments in healthy individuals with respect to their volumes.
How would we know that antidiuretic hormone is acting on the kidney?
Write down all the case data you can remember. If you don't know the number you can simply indicate whether a parameter was normal (N), increased (↑), or decreased (↓).
Tests of transfer
“Runners hyponatremia” related to water overload may occur with long-distance races. You are advising the medical support team of next year's Two Oceans Ultramarathon. List all possible “risk factors” that could identify runners with a greater likelihood of developing acute hyponatremia during the race.
An athlete has a seizure at the end of a long-distance race. His plasma Na+ concentration is 125 mmol/l. He is given 200 ml of 3% saline over 30 min. However, the followup plasma Na+ concentration is 124 mmol/l and there is no clinical improvement. List the possible reasons why the plasma Na+ concentration did not rise in response to treatment.
How much water would a 72-kg woman have to take in (and retain) to drop her plasma Na+ concentration from 140 to 126 mmol/l? Show your calculations.
A 90-kg male patient developed acute hyponatremia from psychogenic polydipsia. You want to raise his plasma Na+ concentration rapidly from 121 to 126 mmol/l. How many millimoles of Na+ need to be administered? Show your calculations.

Examples of questions designed to test the recall of information and questions to test the transfer of problem solving ability are shown. These are related to the WalkThru case.