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IT IS A VERY HOT SUMMER DAY, YOUR NEIGHBOR STOPS AT YOUR HOUSE AFTER JOGGING 5 MILES.  SHE IS SWEATING AND TELLS YOU SHE FEELS DIZZY AND THIRSTY AND CANT MAKE IT HOME.  YOU CHECK HER BLOOD PRESSURE AND FIND IT TO BE LOW. WHAT COULD YOU DO RIGHT INYOUR HOME TO RAISE HER BLOOD PRESSURE?
HAVE HER DRINK A LARGE GLASS OF COOL WATER
YOUR NEIGHBOR AGAIN COMES TO YOUR DOOR. SHE HAS BEEN RUNNING IN THE SNOW AND IT IS VERY COLD OUTSIDE. SHE HAS A HEADACHE AND HER HEART IS POUNDING. YOU CHECK HER BP AND FIND IT TO BE HIGH. WHAT COULD YOU DO THIS TIME RIGHT IN YOUR HOME TO DECREASE HER BLOOD PRESSURE?
HAVE HER LAY DOWN ON YOUR COUCH
WHICH SITUATION OF ALTERED PERFUSION COULD BE TRIGGERED BY COPD?
VENTILATION PERFUSION MISMATCHING
WHICH MECHANISM INCREASES PERIPHERAL VASCULAR RESISTANCE AND CONTRIBUTES TO THE DEVELOPMENT OF HYPERTENSION?
AIMPAIRED SODIUM EXCRETION BY THE KIDNEYS
WHY IS IT NECESSARY FOR URINE TO BECOME CONCENTRATED BEFORE IT IS EXCRETED?
SEVERE HYPOTENSION AND HYPOVOLEMIA WOULD RESULT IF TUBULAR FILTRATE WERE EXCRETED IN THE FORM IT IS IN WHEN IT LEAVES BOWMANS CAPSULE.  OF THE 125 ML/MIN OF URINARY FILTRATE FORMED IN THE GLOMERULI, ONLY 1 ML IS ACTUALLY EXCRETED WITH THE OTHER 124 ML RETURNED BACK INTO THE BLOOD BY REABSORPTION
WHY WOULD THE INDICATION FOR URINE COLLECTION INFLUENCE THE METHOD SELECTION?
TESTS THAT DETERMIEN THE PRESENCE OF A PATHOGEN REQUIRE STERILE COLLECTION METHODS.  TESTS THAT IDENTIFY URINE CHARACTERISTICS DO NOT NEED STERILE COLLECTION
WHAT MECHANISMS OF INFECTION AND INFLAMMATION MAY CONTRIBUTE TO DAMAGE TO RENAL STRUCTURES?
INFLAMMATORY RESPONSES STIMULATE CHEMICAL MEDIATORS TO WIDEN THE JUNCTIONS BETWEEN ENDOTHELIAL CELLS IN THE RENAL CAPILLARIES IN ORDER TO PROMOTE MOVEMENT OF FLUID OUT OF THE VASCULAR SPACE.  VASODILATION OF ARTERIOLES IS ALSO INDUCED TO BRING MORE BLOOD FLOW TO THE SITE OF INJURY.  THESE MECHANISMS PROVIDE THE NECESSARY IMMUNE CELLS TO SITES OF DAMAGE FORDEFENSE AGAINST PATHOGENS.  EDEMA RESULTING FROM THESE MECHANISMS MAY DIMINISH THE FUNCTION OF THE TISSUE.  OBSTRUCTION OF VASCULAR AND TUBULAR FLOW MAY ALSO RESULT, INCREASING THE RISK OF DAMAGE DUE TO INCREASED PRESSURE IN THE KIDNEYS
REDUCED PERISTALSIS WOULD SLOW THE MOVEMENT OF STOOL THROUGH THE LARGE INTESTINE.  HOW MIGHT THIS AFFECT WATER CONCENTRATION IN THE STOOL?
WATER MOVEMENT OUT OF STOOL CONTINUES AS LONGAS THE STOOL REMAINS IN THE COLON, INCREASING THE RISK FOR CONSTIPATION
WHAT ARE SOME COMMON REASONS THAT INTESTINAL MOBILITY CAN BE REDUCED, LEADING TO SLOWED INTESTINAL SMOOTH MUSCLE CONTRACTION?
INTESTINAL MOTILITY CAN BE SLOWED BY REDUCED ACTIVITY, MEDICATIONS THAT ALTER MEUROMUSCULAR CONDUCTION, AGING, FREQUENT USE OF LAXATIVES, AND FACTORS CONTRIBUTING TO CONSTIPATION.
WHAT WOULD YOU EXPECT STOOL IN THE ASCENDING COLON TO HAVE MORE WATER CONTENT THAN STOOL IN THE DESCENDING COLON?
INCREASING WATER IS ABSORBED FROM FECAL MATTER AS IT IS PROPELLED THROUGH THE LENGTH OF THE LARGE INTESTINE.  FECAL MATTER FORM THE CECUM INTO THE ASCENDING COLON RETAINS MUCH OF ITS WATER CONTENT.  STOOL AT THE DISTAL END OF THE DESCENDING COLON HAS LOWER WATER CONTENT REFLECTING THAT OF NORMAL STOOL.
WHY DO BLOODY STOOLS SUGGEST THE POTENTIAL DIAGNOSIS OF CANCER?
THE BLOOD FLOW DEMANDS PLACED BY THE NEOPLASTIC CELLS DEPRIVE NEIGHBORING TISSUES OF ADEQUATE OXYGEN AND OTHER NUTRIENTS RESULTING IN TISSUE ISCHEMIA AND NECROSIS.  THE TUMOR CELLS CAN ALSO SECRETE ENZYMES THAT DEGRADE THE EXTRACELLULAR MATRIX AND ALLOW THE TUMOR TO MOVE INTO NEIGHBORING TISUES.  TUMOR GROWTH BEGINS TO ERODE THE GI WALL PROMOTING BLOOD ENTRY INTO THE GI TRACT TO BE INCORPORATED INTO STOOL
WHY ARE THE PEOPLE WITH HYPERPARATHYROIDISM AND HYPERCALCIURIA AT RISK FOR DEVELOPMENT OF RENAL CALCULI?
ELEVATED SERUM CALCIUM LEVELS ARE CHARACTERISTIC IN HYPERPARATHYROIDISM AND HYPERCALCIURIA.  IN PEOPLE AFFECTED BY THESE CONDITIONS, THE LARGE INTESTINE ABSORBS TOO MUCH CALCIUM.  EXCESS CALCIUM IN THE URINARY FILTRATE IS MORE LIKELY TO PRECIPITATE, PROMOTING THE DEVELOPMENT OF KIDNEY STONES.
WHY DO INDIVIDUALS SUFFERING FROM RENAL FAILURE BECOME ANEMIC?
THE HORMONE ERYTHROPOIETIN, ACTS ON THE BONE MARROW AND IS A STRONG INDUCER OF RED BLOOD CELL PRODUCTION.  DAMAGE AND REDUCED FUNCTION OF THE KIDNEYS RESULTS IN DECREASED PRODUCTION OF ERYTHROPOIETIN, THEREFORE, LESS STIMULUS TO PRODUCE RBC RESULTING IN ANEMIA.
WHY IS THE DIAGNOSIS OF NONRETENTIVE ENCOPRESIS LIMITED TO CHILDREN AT LEAST 4 YS OF AGE?
AS CHILDREN AGE, THEIR NEUROLOGIC SYSTEM CONTINUES TO DEVELOP, SO THAT THEY BECOME ABLE TO CONTROL ELIMINAITON OF BOTH URINE AND STOOL.  INTENTIONAL WITHOLDING OF STOOL ALSO REQUIRES WELL DEVELOPED NEURAL CONTROL IN ORDER TO INHIBIT THE RECTAL REFLEX AND URGE FOR STOOL ELIMINATION.  CHILDREN LESS THAN 4 YEARS OF AGE MAY NOT BE DEVELOPMENTALLY ABLE TO ACHIEVE THIS RESULT, EVEN IF IT IS DESIRED, AND THEREFORE ARE NOT CONSIDERED WHEN APPLYING THESE DIAGNOSTIC CRITERIA.
WHAT PROVIDES THE MOST OBJECTIVE MEASURMENT OF RENAL DYSFUNCTION?
GLOMERULAR FILTRATION RATE
A CHARACTERISTIC CHANGE IN STOOL THAT MAY INDICATE THE PRESENCE OF BLOOD INCLUDES WHICH ONE OF THE FOLLOWING?
MELENA
WHICH DIAGNOSTIC PROCEDURE ALLOWS ANALYSIS OF THE ENTIRE LARGE COLON?
COLONOSCOPY
WHICH FOOD SHOULD BE AVOIDED IN PEOPLE WITH RENAL CALCULI?
STRAWBERRIES
WHICH FOOD SHOULD BE AVOIDED IN PEOPLE WITH DIVERTICULAR DISEASE?
STRAWBERRIES
WHICH TYPE OF URINARY INCONTINENCE CAN BE ATTRIBUTED TO MUSCLE OVERACTIVITY
URGE INCONTINENCE
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