Which of the following statements about normal salt and water balance are true? A. The products of catabolism may be excreted by as little as 300 ml. of urine per day. B. The lungs represent the primary source of insensible water loss. C. The normal daily insensible water loss is 600 to 900 ml. D. Excessive cell catabolism causes significant loss of total body water. E. In normal humans, urine represents the greatest source of daily water loss.

Which of the following statements about normal salt and water balance are true? A.  The products of catabolism may be excreted by as little as 300 ml. of urine per day. B.  The lungs represent the primary source of insensible water loss. C.  The normal daily insensible water loss is 600 to 900 ml. D.  Excessive cell catabolism causes significant loss of total body water. E.  In normal humans, urine represents the greatest source of daily water loss.
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Answer: CE  DISCUSSION: The skin is the primary source of insensible water loss. Including losses from the lungs, this averages 600 to 900 ml. per day. Catabolism liberates “water of solution.” In normal humans, urine represents the greatest source of water loss. The patient deprived of external access to water must still excrete a minimum of 500 to 800 ml. of urine per day to expel the products of catabolism
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Last Answer : Answer : A

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Description : Which of the following statements(s) is/are true concerning human energy requirement? a. In normal subjects, less than 5% of basal energy requirement is spent on cardiac output and the ... d. Similar increases in energy expenditures are associated with elective surgery and trauma or thermal injury

Last Answer : Answer: a, c Basal energy requirements are measured with the subject at rest when no external work is being done; the energy is used mainly for transport and synthetic work within cells. A ... average-sized adult who sustains a major burn rarely may require more than 3500 kcal/day for maintenance

Answer: b Metabolic response to injury results in increased energy expenditure. If energy intake is less than expenditure, oxidation of body fat stores and erosion of lean body mass will occur with resultant loss of weight. When weight loss exceeds 10–15% of body weight, the complications of malnutrition interact with disease processes, with increased morbidity and mortality rates. The goal of nutritional support is maintenance of body cell mass and limitation of weight loss to less than 10% preinjury. The major impact of nutritional support in the trauma patient is to aid host defense. Under-nutrition may compromise the available host defense mechanism and may thus increase the likelihood of invasive sepsis, multiple organ system failure, and death. Resuscitation, oxygenation and arrest

Description : Answer: b Metabolic response to injury results in increased energy expenditure. If energy intake is less than expenditure, oxidation of body fat stores and erosion of lean body mass will occur ... requirements, caloric requirements should be distributed at a ratio of 70% as glucose and 30% as fat

Last Answer : Which of the following statement(s) is/are true concerning body fuel reserves? a. The largest fuel reserve in the body is skeletal muscle b. Fat provides about 9 calories/gram c. Free glucose and glycogen stores are a trivial fuel reserve d. Body protein is a valuable storage form of energy

In the nutritional support of patients with cancer, which of the following statements is/are true? A. Nutritional support benefits the patient's lean body mass but does not enable the tumor to grow. B. In experimental animals, the growth of implanted tumors is directly proportional to the amount of calories and protein supplied. C. Prospective randomized trials of nutritional support utilizing chemotherapy and radiation therapy have revealed benefits to patients receiving total parenteral nutrition. D. Studies of nutritional support for patients with cancer about to undergo surgery revealed decreased morbidity and mortality, especially morbidity from sepsis.

Description : In the nutritional support of patients with cancer, which of the following statements is/are true? A. Nutritional support benefits the patient's lean body mass but does not enable ... with cancer about to undergo surgery revealed decreased morbidity and mortality, especially morbidity from sepsis.

Last Answer : Answer: B DISCUSSION: The problem with the patient with cancer is a very vexing one. Clearly, one of the metabolic effects of cancer, cachexia, affects patients in the last quartile ... undoubtedly reveal that there are certain nutrients that tumors require, which probably should be best avoided

Which of the following statement(s) is/are true concerning metabolic derangements in sepsis and the systemic inflammatory response syndrome which may follow progressive shock? a. Alterations in glucose metabolism lead to the development of efficient substrate utilization b. A progressive rise in serum triglyceride levels result from less efficient clearance and increased hepatic lipogenesis c. A net negative nitrogen balance occurs due to the oxidative metabolism of proteins to meet energy needs d. The serum aromatic amino acids fall rapidly as they are actively used in oxidative metabolism

Description : Which of the following statement(s) is/are true concerning metabolic derangements in sepsis and the systemic inflammatory response syndrome which may follow progressive shock? a. Alterations in glucose ... The serum aromatic amino acids fall rapidly as they are actively used in oxidative metabolism

Last Answer : Answer: b, c A broad spectrum of metabolic abnormalities become apparent in sepsis and the systemic inflammatory response syndrome following shock. Disruption of the normal cycles of carbohydrate, ... acetyl coenzyme A. This results in reduced serum level of leucine, isoleucine and valine

Which of the following statements regarding endothelial cells in acute inflammation are true? a. Endothelial cells are characterized by phenotypic homogeneity b. Specific patterns of receptor expression regulate leukocyte adherence c. Endothelial cell nitric oxide generation regulates regional blood flow and leukocyte adhesion d. Endothelial cells may be capable of phagocytosis

Description : Which of the following statements regarding endothelial cells in acute inflammation are true? a. Endothelial cells are characterized by phenotypic homogeneity b. Specific patterns of receptor expression ... blood flow and leukocyte adhesion d. Endothelial cells may be capable of phagocytosis

Last Answer : Answer: b, c, d Endothelial cells are increasingly recognized to be phenotypically heterogeneous. Specific receptor molecules are expressed at various sites where they help to direct lymphocytes and ... rather, they possess the ability to direct and focus many aspects of an inflammatory event

Which of the following statements are true of oxidants? A. In addition to their pathophysiologic roles in inflammation, injury, and infection, oxidants also have physiologic roles. B. Oxidants may be generated from activated neutrophils and during reperfusion following a period of ischemia. C. The deleterious effects of oxidants include lipid peroxidation and cell membrane damage, oxidative damage to DNA, and inhibition of adenosine triphosphate (ATP) synthesis. D. The mechanism of ischemia-reperfusion injury involved the catalytic production of superoxide anion (O 2•) by the enzyme xanthine oxidase.

Description : Which of the following statements are true of oxidants? A. In addition to their pathophysiologic roles in inflammation, injury, and infection, oxidants also have physiologic roles. B. Oxidants may ... involved the catalytic production of superoxide anion (O 2 ) by the enzyme xanthine oxidase.

Last Answer : Answer: ABCD DISCUSSION: Oxidants are reactive oxygen metabolites that have both physiologic and pathophysiologic roles. As potent oxidizing agents, oxidants are involved in cytochrome P ... leukocyte infiltration and activation, causing further tissue damage by the release of cytotoxic proteases

Which rate is the greatest 800 miles per 16 hours 1500 miles per 50 hours 600 miles per 15 hours or 900 miles per 20 hours?

Description : Which rate is the greatest 800 miles per 16 hours 1500 miles per 50 hours 600 miles per 15 hours or 900 miles per 20 hours?

Last Answer : Convert them all to the same per x hours and then compare them.You can either convert them all to unit rates (x = 1) or some otherrate (eg lcm of 16, 50, 15 and 20).I'll use unit rates:800 miles ... 800 miles per 16 hours > 900 miles per 20 hours > 600miles per 15 hours > 1500 miles per 50 hours.

Which of the following statement(s) is/are correct concerning the cardiovascular response to shock? a. Changes in cardiac contractile function shift the Frank Starling curve up and down b. Venoconstriction from skeletal muscle is a significant contributor to the restoration of blood volume with shock c. Arterial vasoconstriction affects all vascular beds equally d. The total circulating blood volume is equally split between the arterial and venous system

Description : Which of the following statement(s) is/are correct concerning the cardiovascular response to shock? a. Changes in cardiac contractile function shift the Frank Starling curve up and down b. ... d. The total circulating blood volume is equally split between the arterial and venous system

Last Answer : Answer: a Central in the general cardiovascular response to shock is the action of the heart itself. The principle determinants of cardiac function in the normal heart are the volume of blood ... Blood flow to the skin is sacrificed early, followed by that to the kidneys and splanchnic viscera

Which of the following statements about respiratory acidosis are true? A. Compensation occurs by a shift of chloride out of the red blood cells. B. Renal compensation occurs rapidly. C. Retention of bicarbonate and increased ammonia formation are normal compensatory mechanisms. D. Narcotic administration is an unusual cause of respiratory acidosis. E. The ratio of bicarbonate to carbonic acid is less than 20:1.

Description : Which of the following statements about respiratory acidosis are true? A. Compensation occurs by a shift of chloride out of the red blood cells. B. Renal compensation occurs rapidly. C. Retention of ... of respiratory acidosis. E. The ratio of bicarbonate to carbonic acid is less than 20:1.

Last Answer : Answer: CE DISCUSSION: Renal compensation for acute hypoventilation is relatively slow. Depression of the respiratory center by morphine can lead to respiratory acidosis. Renal retention of bicarbonate, ... into red cells combine to increase the ratio of bicarbonate to carbonic acid to 20:1

Which of the following statement(s) is/are true concerning excessive scarring processes? a. Keloids occur randomly regardless of gender or race b. Hypertrophic scars and keloid are histologically different c. Keloids tend to develop early and hypertrophic scars late after the surgical injury d. Simple reexcision and closure of a hypertrophic scar can be useful in certain situations such as a wound closed by secondary intention

Description : Which of the following statement(s) is/are true concerning excessive scarring processes? a. Keloids occur randomly regardless of gender or race b. Hypertrophic scars and keloid are histologically different ... scar can be useful in certain situations such as a wound closed by secondary intention

Last Answer : Answer: d True keloids are uncommon and occur predominantly in dark skinned people with a genetic predisposition for keloid formation. In most cases, the gene appears to be ... subside. Hypertrophic scars usually develop within the first month after wounding and often subside gradually

Which of the following statement(s) concerning laboratory studies used in monitoring a patient with intravenous heparinization is/are correct? a. The platelet count should be followed because of the risk of heparin-associated thrombocytopenia b. The prothrombin time should be observed if prolonged treatment is necessary c. The activated partial thromboplastin time (aPTT) should be maintained at approximately 1.5 times normal d. The serum creatinine should be measured daily to allow adjustments in dose based on renal function

Description : Which of the following statement(s) concerning laboratory studies used in monitoring a patient with intravenous heparinization is/are correct? a. The platelet count should be followed because of the ... serum creatinine should be measured daily to allow adjustments in dose based on renal function

Last Answer : Answer: a, c In monitoring the effect of heparin, an activated partial thromboplastin time (aPTT) of 1.5 control or a thrombin clotting time (TCT) of 2 times control reflects adequate ... system. Therefore the dose of heparin need not be adjusted in cases of liver or renal dysfunction

Which of the following statements regarding the complement system are true? a. Complement activation yields products which are directly cytotoxic as well as products which act indirectly via activated leukocytes b. Complement products referred to as anaphylatoxins include C1, C3a, C4a, and C5a c. The principal role of C5a is in bacterial opsonization d. The alternative and classical pathways converge proximal to generating the membrane attack complex (C5b-9)

Description : Which of the following statements regarding the complement system are true? a. Complement activation yields products which are directly cytotoxic as well as products which act indirectly via activated ... and classical pathways converge proximal to generating the membrane attack complex (C5b-9)

Last Answer : Answer: a, d The complement system is composed of two different but linked sequences, the classic and alternative pathways. The pathways involve serum proteins that act to amplify the inflammatory-immune ... the C5 level proximal to generating the membrane attack complex (C5b-9) (Figure 6-3)

Transfusions of blood products can be associated with a number of complications including immediate and delayed hemolytic reactions; nonhemolytic reactions; infectious disease transmission; and complications of massive transfusions. Which of the following statements are true concerning complications of blood transfusions? a. Immediate hemolytic transfusion reactions are caused by major ABO blood group incompatibility b. Nonhemolytic transfusion reactions are usually due to RH incompatibility and are therefore more common in women of childbearing age c. The most common complication of massive blood transfusion is dilutional thrombocytopenia d. Routine impaired calcium supplementation is necessary during most massive transfusion episodes

Description : Transfusions of blood products can be associated with a number of complications including immediate and delayed hemolytic reactions; nonhemolytic reactions; infectious disease transmission; and ... d. Routine impaired calcium supplementation is necessary during most massive transfusion episodes

Last Answer : Answer: a, c Immediate hemolytic reactions are usually caused by blood group ABO incompatibility although they may be caused by antigens of other blood group systems ... when associated with massive transfusion during complex intraoperative procedures such as thoracoabdominal aneurysm resection

Which of the following statements regarding the transmission of infectious agents through blood transfusions is/are true? A. The transmission rates for human immunodeficiency virus (HIV) have been decreasing progressively since the early 1980s. B. The transmission rates of hepatitis have been decreasing steadily since the 1980s. C. Cytomegalovirus (CMV) is the infectious agent most commonly transmitted in blood. D. Severely immunocompromised patients (such as patients undergoing transplantation) should receive specially screened blood products.

Description : Which of the following statements regarding the transmission of infectious agents through blood transfusions is/are true? A. The transmission rates for human immunodeficiency virus (HIV) ... patients (such as patients undergoing transplantation) should receive specially screened blood products.

Last Answer : Answer: ABCD DISCUSSION: The incidence of both HIV and hepatitis transmitted via blood transfusions has been steadily decreasing since the 1980s. This is related to improved ... , severely compromised patients such as those undergoing transplantation should receive CMV-negative blood products

Which of the following statements regarding whole blood transfusion is/are correct? A. Whole blood is the most commonly used red cell preparation for transfusion in the United States. B. Whole blood is effective in the replacement of acute blood loss. C. Most blood banks in the United States have large supplies of whole blood available. D. The use of whole blood produces higher rates of disease transmission than the use of individual component therapies.

Description : Which of the following statements regarding whole blood transfusion is/are correct? A. Whole blood is the most commonly used red cell preparation for transfusion in the United States. B. ... whole blood produces higher rates of disease transmission than the use of individual component therapies.

Last Answer : Answer: B DISCUSSION: Whole blood is effective as a replacement fluid for acute blood loss because it provides both volume and oxygen-carrying capacity (red blood cells). It is rarely used in the ... the use of packed red blood cells, fresh frozen plasma, and platelets, each from a different donor