By M. Narkam. Boston College. 2017.

Her hematocrit ratio is (E) Secretion is stimulated by a rise in (B) Dehydration plasma ionized Ca2 (C) Diabetes insipidus 0 order 60mg starlix overnight delivery. Aldosterone acts on cortical collecting (D) Diabetes mellitus (B) 625 mL ducts to (E) Renal failure (A) Decrease K secretion 15 discount starlix 120mg fast delivery. Which of the following (D) Increase K secretion changes would be expected? Which of the following leads to decreased Na reabsorption by the (E) Increase water permeability (A) Plasma aldosterone level will rise kidneys? In response to an increase in GFR, the (B) Plasma angiotensin I level will rise (A) An increase in central blood proximal tubule and the loop of Henle (C) Plasma angiotensin II level will rise volume demonstrate an increase in the rate of (D) Plasma bradykinin level will fall Na reabsorption. This phenomenon is (E) Plasma renin level will fall (B) An increase in colloid osmotic called 16. If a person consumes a high-K diet, pressure in the peritubular capillaries (A) Autoregulation the majority of K excreted in the (C) An increase in GFR (D) An increase in plasma aldosterone (B) Glomerulotubular balance urine is derived from level (C) Mineralocorticoid escape (A) Glomerular filtrate (D) Saturation of tubular transport (B) K that is not reabsorbed in the (E) An increase in renal sympathetic nerve activity (E) Tubuloglomerular feedback proximal tubule (continued) CHAPTER 24 The Regulation of Fluid and Electrolyte Balance 425 (C) K secreted in the loop of Henle isotonic saline (0. Renal potassium transport: medullary-collecting duct (C) Plasma arginine vasopressin (AVP) Mechanisms and regulation. Which of the following set of values concentration Physiol 1998;274:F817–F833. Renal Physiol- kg H2O) (mEq/L) kg H2O) explanation for this is that the ogy. Louis: Mosby-Year (A) 300 145 100 (A) Effective arterial blood volume is Book, 2001. New concepts concerning the (C) 285 140 600 (B) Extracellular fluid volume is regulation of renal phosphate excre- (D) 270 130 450 decreased tion. News Physiol Sci (E) 285 140 1,200 (C) Extracellular fluid volume is 1997;12:211–214. Renal magnesium handling: with uncontrolled diabetes mellitus (D) Total blood volume is decreased New insights in understanding old has a plasma [K ] of 4. The body is constantly threatened by acid resulting from (mainly proteins and organic phosphates), and by meta- diet and metabolism. Respiratory acidosis is an abnormal process characterized lungs, and the kidneys.

The GPi and SNr output is inhibitory via neurons that use GABA as the neurotransmitter purchase starlix 60 mg without prescription. The Basal Ganglia Are Extensively Interconnected The internal pathway circuits link the various nuclei of Although the circuitry of the basal ganglia appears complex the basal ganglia trusted 60 mg starlix. The globus pallidus externa (GPe), the at first glance, it can be simplified into input, output, and subthalamic nucleus, and the pars compacta region of the internal pathways (Fig. Input is derived from the substantia nigra (SNc) are the nuclei in these pathways. The cerebral cortex and is directed to the striatum and the sub- GPe receives inhibitory input from the striatum via GABA- thalamic nucleus. The output of the GPe is also inhibitory striatum is termed the medium spiny neuron, based on its via GABA release and is directed to the GPi and the sub- cell body size and dendritic structure. The subthalamic nucleus output is excita- receives input from all of the cerebral cortex except for the tory and is directed to the GPi and the SNr. The input is roughly so- GPe-subthalamic nucleus-GPi circuit has been termed the matotopic and is via neurons that use glutamate as the neu- indirect pathway in contrast to the direct pathway of stria- rotransmitter. Input to the sub- put from the striatum and produces output back to the stria- thalamus is from the cortical areas concerned with motor tum via dopamine-releasing neurons. The output can be function, including eye movement, and is also via gluta- either excitatory or inhibitory depending on the receptor mate-releasing neurons. The action of the Basal ganglia output is from the internal segment of the SNc may modulate cortical input to the striatum. The GPi output is directed to ventrolateral and ventral The Functions of the Basal Ganglia anterior nuclei of the thalamus, which feed back to the cor- Are Partially Revealed by Disease tical motor areas. The output of the GPi is also directed to a region in the upper brainstem termed the midbrain ex- Basal ganglia diseases produce profound motor dysfunction trapyramidal area. This latter area then projects to the neu- in humans and experimental animals. The substantia nigra output sult in reduced motor activity, hypokinesis, or abnormally arises from the pars reticulata (SNr), which is histologically enhanced activity, hyperkinesis. Two well-known neuro- 104 PART II NEUROPHYSIOLOGY logical conditions that show histological abnormality in secondary to the loss of inhibitory influence of the striatum basal ganglia structures, Parkinson’s disease and Hunting- through the direct pathway.

A high correlation between the extent of cognitive impair- ment and indices of disability has not been demonstrated c buy 60 mg starlix overnight delivery. There is a strong positive correlation between disease course and the development of cognitive impairment 28 purchase 60mg starlix amex. In which of the following scenarios is neuropsychologic evalua- tion not indicated? An employer reports that a patient is not working as produc- tively as he had been b. A baseline assessment of cognitive function is desired prior to initiating immunomodulating therapy c. A family is concerned that a patient may have cognitive impairment, but the patient denies any problems and there is no clinical evidence for such impairment d. The patient reports cognitive deficits that, although subtle or fluctuating, may have functional impact 29. Which of the following strategies is unlikely to help patients with severe cognitive deficits? Which of the following is probably the best approach that nurs- es can adopt when addressing quality of life issues with people with MS? Nurses should recognize that each patient may have different expectations and aspirations c. It is important to use quality of life questionnaires before ini- tiating conversations about quality of life 31. The degree of disability is the sole determinant of quality of life in MS b. Recognizing the need to respond to change is more important than the ability to socialize in MS c.