What are the manifestations of neurogenic shock? (Select all that apply, one, some, or all.)

What are the interventions used to treat septic shock.  (Select all that apply, one, some, or all.)

A patient is being admitted with septic shock. The nurse appreciates that the key to treatment is finding the cause of the infection. Which cultures would the nurse obtain before initiating antibiotic therapy? (Select all that apply, one, some, or all.)

A patient is admitted with a gastrointestinal hemorrhage due to esophagogastric varices. The patient has been started on a vasopressin drip. Which side effect is the nurse monitoring for?

A patient has been admitted with acute liver failure. Which interventions would the nurse expect as part of the interprofessional collaborative management plan? (Select all that apply, one, some, or all.)

Upload an image of your drawings. About 30% of Thr in humans is degraded by the threonine dehydratase reaction. This reaction is parallel to the serine dehydratase reaction. The product of this Thr reaction is α – ketobutyrate (CH3CH2COCO2-). Write out the mechanism for this reaction. 

Mini case study: Alex is a 15-year-old Caucasian male, who is unable to perform strenuous exercise because he lacks the enzyme to effectively breakdown glycogen in the muscles. Alex’s blood was tested for alanine content. In a normal person, you would expect that blood alanine would increase during strenuous anaerobic exercise. But in Alex’s blood samples, there is a decrease in alanine concentration, leading you to believe that Alex’s muscle cells are taking up alanine rather than releasing it. Why would blood alanine concentrations increase in a normal person? (2 pts.) Hint: Think of the muscle fuel supply, the connection between pyruvate and alanine, and the role of nitrogen metabolism in the liver as well as, the liver’s role in gluconeogenesis.  Why do blood alanine concentrations decrease in Alex? (2 pts.)

Upload an image of your drawing. Malate in the cytosol may be converted to pyruvate in a single step in a reaction catalyzed by malic enzyme. This reaction requires the cofactor NADP+ and is analogous to one of the reactions in the citric acid cycle This reaction along with the pentose phosphate pathway, provides reducing equivalents for fatty acid biosynthesis. Draw out this reaction showing the structures or names of the substrate, products and cofactors. Identify which step in the citric acid cycle that this reaction is most similar to.

Upload an image of your drawings.   One of the intermediates in the biosynthesis of epinephrine is the amino acid L-dopa, which has two phenolic OH groups at the 3 and 4 positions of the benzene ring of Phe. Following the PLP mediated decarboxylation of L-dopa, the side chain alkyl group is hydroxylated to form the hormone norepinephrine. The final step in the biosynthesis of epinephrine is N-methylation of norepinephrine to form epinephrine by SAMe (S-adenosy methionine). Outline the series of reactions that would take a carbon atom from either Ser or Gly and deliver it as a methyl group to norepinephrine to form epinephrine. Show all necessary cofactors. You may use names, structures, or acceptable abbreviations. (4 pts.) Following the transfer of a methyl group, SAMe is converted to homocysteine. High levels of homocysteine in the blood have been correlated with coronary heart disease, stroke, atherosclerosis, neural tube defects, and dementia in the elderly. Homocysteine can react with Ser with the loss of water to form cystathionine. Cystathionine is cleaved to form Cys and α-ketobutyrate in a PLP dependent reaction. Show the series of reactions that converts 

A 20-year-old man was stabbed in the chest with a jackknife (pocket knife) with a blade five centimeters long. The stab wound in the left fourth intercostal space was approximately two centimeters lateral to the body of the sternum. What chamber of the heart would likely be injured?