Pee og a ‘A a-yearald mans bog one emergency depanment stra mat’ vacle calisen, ets un dominate ‘races. The patent has ne senicantmedca Nistor and ates no medeauos. He est smoxe ur dks B12 achat beverages ‘ny flo rsa is 8040 mm Hp ancplee = 0TMn. mesa raiesaton eons rs ties. sng mene eesies anion ct ‘several unscf paced re bes ces. urn anspor the tensive cre unt the Fant eps ngng sensations res ae oes. ‘Scum nized ccm vel 4 mf roma 48.55) Whchet he lng the mostly cane oth poets een pons? ‘rma mediates red bond cl rembrare Saag ‘Cacur chetaton by sistance nthe wanted eos ‘cro ska om ed bod ces dunn peansoson strane Inceased renal tr excretion of calm ial CaPee og a ‘A a-yearald mans bog one emergency depanment stra mat’ vacle calisen, ets un dominate ‘races. The patent has ne senicantmedca Nistor and ates no medeauos. He est smoxe ur dks B12 achat beverages ‘ny flo rsa is 8040 mm Hp ancplee = 0TMn. mesa raiesaton eons rs ties. sng mene eesies anion ct ‘several unscf paced re bes ces. urn anspor the tensive cre unt the Fant eps ngng sensations res ae oes. ‘Scum nized ccm vel 4 mf roma 48.55) Whchet he lng the mostly cane oth poets een pons? A. probed mediated re lod cal membre dara (8) 1. Catoum chat bya substan inte transis ood (71%) 6. Gero leakage fom redo cls dng easton oage 4) nesses renal bul exciton of aon (6), elec factor contest nied mck (1%) ial Caar) GB aie a ee ‘Acute hypocalcemia + Nea super (prahirodecony) + Pancreas + Tumor yes srrame + Cheltion bod tae) wanstin + Pipher sewemuscuarextably (ary) © Chvosee sgn fai muscle spasm) Cia! teties| © Trousseav san carropedal sf2s7) 1 Pareshesie,yperaeia “reamment | + WV eaisum guconateioeae ‘This pater has synptratc mpocicemia (ep, patesnesas) oloung high-volume Blood ransuslon. Foro tage donated ocd gereally med vn solutes covaning erate artcoaguart Flowing Ynsisin, uae is rapt meebsied to beatae nthe ver however, when ge volunes ofc are tasiesedrapdh he excess ciate can chelate callum rte asa, leading hypocalcemia ue {oceceneed zum eed calzum eeneraion, This fest common uth vary highancuron ates eg "Oua) bat can aoe ser lever ie patents th ncejig epatensutcency ep aca Wer dsea5) ‘ther compizatons high vlumetarsuson nclue deletion of coanlaion actors nd lune veo (hota Aand €)Artbotyedatedhsresisistpicaly cased by tansfuionc ABO-ncowpstle Youd. Chavet nicl ncngs Ince ver tackor flank pan acute rey nun, an hemoglobins. The pray elecohte compton s hperaiemia ue trea of inraceliar possum. Hypetalemia can lobe seen de to leakog of passium fom redeas cung serge. Hower, hypocalcemia would (Chole D) Ate hypocaleema du increase eral acum excretion canbe seen in hypoparayrien. This commen encountered 2s Ca ialaren “Ths pater has sympa ypocicemia (ep pate) oloung higholure Blood wansuslon Foro rage donated ocd gerealy maed wh slutonscortaning era artcoaguart. Folowng Vansusin, cae is apidy metboized to beabenate nthe ve, however, whe ge velunes ofbee are ranted apd he excess ciate can eel callum rtoiasr, adn fo hypocaleamla 2 to ceceased sum eed calcum ceneiaon. This mest comer wth very hgh arson ates en ~9 ish). bit tcan ao be seen alaver es wpa wth ncejing epatensutcency ep aca Wer 3Sea5) ‘ther compizatons high vlumetarsusoninlue deletion of coanation actors nd lune veo (holes Aand G)Artbotynedatachenlysisticaly cased by Yanssin ot ABO-ncowpstle ood. Characters nical tangs Incloe fever backorfan pan acu rey nun, and hemoglobins. The may lecohte compton hyperemia ue tease of Innaceliar possum. Hypetalemiacan lobe Seen de leakage of passim fom rect cng sere. However hypocalcemia woul (Cnoieeb) ste hpocleeaai o cesta eal ccm excretion canbe sean in hypparshyrote. This comment enccnteted 22 23 camplcaion of hyoider cher reck suger wth nadveert ru x reoval afthe parathyroid olnis.Abdorira and owe exveity una would et tet pray ction (Ghote &) Rrabcomycrs cay reser wih muscle pained ine ie, megitinua) and elevated eae nase. Reeaseof ‘nracldmphorpale for muse alle con pracpatecalnur stain domaged muni ndlendtohypoclcera tlhe typeay a delayed aig (24.72 nous ate aun). ‘educations objective: Crate asap high olen Hood anc can chat paema calcu, ending tahypocscamia hich suse perp newomuscat exci (23 paresmesa, muscle spasms). Ths most canon wih vy fad ans aes, ba can a0 Seen at lower tes pation wah apa nsutoancy because cas metbolzd by thee + Pyporlcema lo wauna patents ect massive rans,p poh dont eo 2 2 Ss Wf US sy] Aczyeattrancones otc wasting gu Te pt es stage 2s ma one 2 | Serta aay eames a vere saga, ‘ vemconaateeine an = Zor = — Seumseunse ——anaet ema sort a Tans sauraton 0 (romal 20%-50%) ‘Aer appropri weamertis ints fers anema, hich of he folowing change isos ket occur ints patents eto cls? OA Seareasein nee poxparpyin tees OB Oecreaseinetadcendotata detain © ©: increase nprogenir cel retin OB. Seen of hmegitin heel om OE Smecrenizaton of mua an cosas maraon o! ial2 pedo = ONZE Gam| As2yerad rancor tan we Tet tg snp? cy me SSeS ae . —— essa 5 ne: — soto = ay es Tainan oma Senate son Tans sauraton 0 (romal 20%-50%) ‘Aer appropri weamertis ints fers anema, ch of he folowing change isos ike toxcr ints patents eto cls? ‘A. Dewease ne protpapym eves 22) 8. Decease in rtelerdtaldesttion (2) ©. lncreasenproceniar cal dentition (576) . Seach efnamegitn to heft rm (2%) Smetrenabon of ncaa cyonlasnc maturation (6) o! ialaren ates win onic Mdney dseas CAD) cen deep nomacye anemia he omar Mion ate worsens duo nadequste production of erphropetin (EPO), a gheeprotannomone proce y prtibuar freee ne renal conse EPO leases ihe eoesteam nresponse 1 real ssc hypoxia ard subsequent cs on eye eget eset conforming Unt ces) the enema to reduce apepons an crease dferenation to ate ood cal ‘Athovah hey iis espana ane by ineasing EPO lev po 10000414 paterts wth CKD have conc tarry damage toreral EPO producing cels ard are en rable e generate et eves of EPO to main adeausteexrtroois. These inva ae chen teaes nh =ymhati fom of EPO [oa essindutepoin) i aupplemen!nnac EPO rotten a tml efopaers ‘Because syne loms of EPO can apy delete won tvs (eo creased cd cal peace), pater shuld be tested Fon eficency pro uestnent wth ese apet. (roiee A) Przpepyins heme recurs) ae eleatn pans wih fon detcency anema. eaten of von decency ane eon Ssipplenertater ead ome conerson ef prtcparpyinsta here, mereby eaverg Ne toa evs, Patents win on decency ‘anaia usualy havelon serum fern ves and vanstrncaraon. (rete 8) War aicinmune nenaiye ana scares by arabes aga artgens thee ell manrane test shagocoe in terete ten (9 pee). Auman hey anema fe uavaly Vested with mmune-ugpessng opens (@9, reznsone), which St aribosy produc and rece ed cel estucion. The patent wih 3 orm iub ees uk have here aremia (heieeD) sicko cl nama is caused by mutansin the beta goin chain which essin tbe palmerzaton of deoxygenated henod.tin molecules (Scking).Treatnent wih tones induces expression of etal hemogsb (which is urate byte sexe mutton) over act henagebin, hereby prevening pmeraten of hemedsbin molecules. (Chole) Oefosney famine regains ae) pars mils’ sot meablam whch sun aed preston ot centivocye pecusosinthe bone marow. Relacenert of tan Ble corecs the anemaby meron nucee raion agate ane typclyaezaate wth marcy (emvaed mea apse ature) sper ‘Education objective:aren ‘Aaah reaty niu espandta anemia by ere EPO vl up 10,0004 paterts wth CKD have cone arty damage torenal EPO odueng cele and are fen nse generat suerte cf EPO to martan adequate eyes. These nel a ‘fen teaes we syrtes foms of BPO (en eoetn,darbepetin mo suglement ris EPO froducten ad striate eyhoodess ‘eens syne ora of EPO can apy deplete on tres (nto nereaand redo al puter) pater hal be tested or on etcency pro veanent Wh ese apets, (Ghote A) Protcpopins here procure) are clean patents with or defdency arena, Teatent tron dency ane ea on Sipplenertate) ead me conerson ef ptopapyinsiahere, erty fesicng te rtoparpye eras. Paes wn on decency anemia usualy havelon serum fer ves ad arse saan (hoje B) iam auicinmne enolic meniascharaceize by artbecies against artigens on tered cll mentrane hat est in prapoeyios ine reteiondonel tam ag pee). Auonmuneenclyeanema uly Yai wh mmune-suppesingspens (69, precncone) wn la artéadyprodicton and ae red cel deacon ‘Ths pat wh a eal ub ees ute rave heelys arama. (rete Dy sitet nema caused by mutans in he beta lon chan whch ess nthe pamerzaten of eoxygenaeahenogotn ‘molecules (sen). Treatment wih hykonyrea induces expression of etal bamogba (wich is unaleted by bese mutton) ove adult enagebn, rey preveing ymeraten of henegsbn maocues. (rete ) Cetcency of vame Bate (negaodashc aema) pars hide cod metablsn whe sun slowed rodent centage precursors int bane marow. Replaconert of tame Sole cored the anema by mpromrg neces rata, Megat anemia scaly associate wth mary (erated mea corpuscular vome) aroma Educational cbective: rytropoitn (PO) is podicd by perl cast cols into rnacorex in response to deceased renal angen dehiry EPO acon centoce pecs inthe bone marow te eease ed lod co eucon, Patents th conc ere disease cen have cara eal [EPO predung cel wach result m nomecyic mer References + Remletiapotin rong celsin heath and sessoQzamin Q ramon Ci recet Gass ToNew Cad | Exeeng Cartar) GB PE a ee (Ghote A) Procpcpin iene precusors are clean pars wih on defen anemia, Teaent fron decency ane ea 00 _nplenertater) leads tote somerzon cf pcepaphyinsta here theety recog te topes ere. Patent wih an dency anemia usualy hvelon serum fern ves and area saan (GhoieeB) iam autcinmne enolic eniaischaraceize by artbcies against artigens on there cll mentrane ha est in prapoeyinis ine reteiondonel sytem gpa). Auonmuneenclyeanema uly Yate wth mmune-suppesingspens (69 prencone) wen bla artbadyprodicton and aie red cel destucton ‘Ths ptt wh a eal ibn lees ute rave hvac anemia (ree D) Sci cl anama caused by mutans in he bla glo chan whch esa the pomezaten of eowgeratas hemoglobin ‘molecules (song) Treatment win ryeronyea uc expression ofa hemaguba (which uraleted by Pe sexe multi ove at emai, ney peveing fehmerzaten of hanogibin meus (rete ) Cetcency fame Baote(megadasic aema) pars nica meablsn whe sun slowed redcten ot ‘enthoole precuso in tba bane marow Relaconert of lane Bole cored the anemaby mproingnuces ata, Megalstc anemia s wicaly associate wth many (ested mea corpuscular vote) aroma Educaona cbective: Eryropoitn (EO) i podicd by peru tas cols into rna cone response to deceased renal ongen deiery EPO acon centoce pecs in the bone marow te eease ed lod co eucton, Patents th conc here disease cen have carga _EFO-procing cel, which results n nemecyic ane. Reternens Physcleny —Hemataogy 8Oneogy Anema ofiilanmaton o! ialRC) aes Laue OL) ‘4 35.yeaald mans bog oe cmergenydeparmert ser ctapsng ns garage He ecenty bau a cas 1660s carvnibe and Was ‘parm twten he claps. The pst was inside Re garage ut adhe doocalopen. Hest consoousress te wary onthe cro hours whe ergs nang. The pater has no known mada poles and sks o madcatons, He does ot se tbaco, ach, or ick dugs. When othe eloung beste he combate of sings hat wou have been expected nan aerial bed sametaken when (he patent at eanecoueeas? Ceponyhamoglctin(%) P20, men Hgnermal = Mathemogloin 3) rormal =o, ‘5100) Irormal =O 8 % 6 ‘ « % 6 Fy Oe 0 6 ' Oz “0 © 2% ra ialOo ar) GB ‘4 35.yeaald mans bog oe cmergenydeparmert ser ctapsng ns garage He ecenty bau a cas 1660s carvnibe and Was ‘parm twten he claps. The pst was inside Re garage ut adhe doocalopen. Hest consoousress te wary onthe cro hours whe ergs nang. The pater has no known mada poles and sks o madcatons, He does ot se tbaco, ach, or ick dugs. When othe eloung beste he combate of sings hat wou have been expected nan aerial bed sametaken when (he patent at eanecoueeas? Ceponyhamoglctin(%) P20, men Hgnermal = Mathemogloin 3) aa ese “ as « : cs « * rs voo. @ « 1 we) a” « * ~ oe ce Eo ra ial‘Cabon monoeide (CO) 2 clress, adress gs rout the conbusin of cabo. cotaning compounds. CO posaang can cau ater F exposure te azmabe exhaust espa nds WO CRANE cones), We Ske pope verted alos paces, (CO nas 2maor ees en ongencalvery to ssues 1. coin theron an at appronnatly 250 unas a ongen eau he urbe ee nny Ses avaale a cngen. As areal level of CO-bound hemoglobin resreered by earbenyhamoglbin(H8CO) ierave. By deessng the acon of hemoalbn avatar angen indng, CO deceaees te oxygen crying capacty an oxygen content ofc, bt nthe aout ofongen soivadin lana, refeted by he pari pressiecfongen (P30), 2 CO pearing caueeaefturd ht the hemagan angen desccaton carve, reectng a deceaves enn or ongen ould [CO's ees on atl loos oxygen cotert are sen n he raps eon hich sho the over xg content with CO posoing (iio anemia and stars si he asses cue that became eeas0g)y mote ponouced at ncseasngy higher HBC cencenraans (2s does at cee wah anemia Copscoing BCD i orn ialOu L-CS) eee 3, 5 © (holes A.B, ©, and E) CO poring does ot fect aCe art does ot cause meteresibineria. Mthemegctin i ed when the et (ous fon) names onze io Fe (ion), Menenogbnenia sits Nom dog ©gOsue epson, ies 3 wel at rayne detec aa hemoglcbeapaties. ‘Eduction objective: Carton maande (CO) bse hemagabn wth mur Nghe any han ogee reverting o4pen nang henapobN Habs ‘reduces ongenrloadig om temgionin the issues, CO poscnng eases caboryemogirincncenratons bit does ct lc ne aval peers ot nga and ee not petcat mamerogeninems Pryselogy Hematology 8Onsogy Caen reno poisoning a eyCu ee - wa orgen content ment Bod ee” 2 4 5 © (ereies A. 8.6, an) Co gosoing dss ot fe PaO nt ts a cals mamaria Maem i amed un he Fe aus on) nbene'sondzed oF ete von). Menenogebner esis Non di assis (Sapo, eS) a el 2s rae fcance nd Panogennopaines atonal bev aren moras (0) bs nemagebn wn mich ger ny an ong, eter Frevering oxygen Brag anogohn. 380 rotues oygonrioadig fom hanegotin nthe tues CO sosenrg ests aboemogodn crcowatens bt ecesret fet me feralmemreofongen ana does nt preci meheneneinems Physcleny Hematology 8Onesony Caen renoie poisoning a eyOo ar) - wa ‘.5.yearld man wan typatanson an tae NY cane dey disease cones to Re oe er aew.yp The part has had worsens ange {anatow energy over We past several monn bt no ches gana stennes beat. He was revo. nonadherent wih arshypertansve therapy buns aon felonng renter recormnatons since rena ystncion was dagosee 2 yes ago. Bond press i 12878 Hg anauise 68min. Cara auscutason revels an S# curd. The rest of he physcal earnaon surerarkable Labret ests sow omocjie nomacheme nema wth alowreteuscte court Serum on sche areitun normals Tesment ith a ecartinrt ycoprien termane is bagi ar repeat aba testing several Weeks ll tows aningrovernerin Nema ev The eet of Me hhomonoprescrbedfor hs pater are most ay meds by hich ote falowing pathways? OA Aime eaetycie AUP 1 Avacndent acsprosptgase M2 © © anus unas 2sgna vasaucers and avai otvarseipion O08 Near eects OE Prosshaiayinest ina OF Rasmtegensetiated prin erase ial raCu ee - wa ‘.5.yearld man wan typatanson an tae NY cane dey disease cones to Re oe er aew.yp The part has had worsens ange {anatow energy over We past several monn bt no ches gana stennes beat. He was revo. nonadherent wih arshypertansve therapy buns aon felonng renter recormnatons since rena ystncion was dagosee 2 yes ago. Bond press i 12878 Hg anauise 68min. Cara auscutason revels an S# curd. The rest of he physcal earnaon surerarkable Labret ests sow omocjie nomacheme nema wth alowreteuscte court Serum on sche areitun normals Tesment ith a ecartinrt ycoprien termane is bagi ar repeat aba testing several Weeks ll tows aningrovernerin Nema ev The eet of Me hhomonoproscrbedfor hs pater are most ay mediates by hich ote falowing pathways? 1. Aden yoni AMP 6%) 1. Arachne acaphosppase £2 (1%) V6: Janus unas 2sgna vasaucers an atvat ot ansepin 73%) 1. Near ecg (10%) . Phoeghatiinsio Sinase 24) FF Rosritogen sett prt ane) oe LW etemny ca Erythropoietin signal transduction a eyC0 Erythropoietin “= —@ “anus Kase’ activation & receptor Q phosphorylation pears aie ee ee aoe uwona ators win nie Kidney cleeas (CxO) fen devep nomeertie anemia 3 the omer ration at decines, de to a nab gore eateries of ntropoein EPO). ERO isa gcopoen osucedby perv frost celine eal catenin ‘esperse to tssue pana (2s sen wh arama), Healy ara wcease EPO peducsan wp 1DC0Dod espa enema ba stents wih CKO nave van ena flanesin at mages EPO-peduelng cel, heey pevening an adequate EPO response “Therion wth CKD ae chen Weated wh recombinant EPO agers (9, pact, dreepein to suppomert EPO presen,aren vers wth ele hidney dlaease (CD) hen devslep nomeeye anemia 2 the gomeruar ron et decnes, deo a maby ere aeaite artes of entropies EPO). EPO isa gycopoen moses pertvuafrolast ces in he eal caren resporceto tons hyponia or enh nem), Hes ince craze EPO poducson it 1DCOD od nreapors canara ba stents wn CAO nave avn ena iflamerzin ta mages EPO-predueing cals, ety prevenng an atequale EPO resprse. “het, tons wth CKD ae can vested wth recombinant EPO ager (3, pact, daesoete to suppanert EPO pedo, EPO wal tor ne ny ough he Monde eam 2 the bone mon, hte nde oa suas reer oneytreytaclany-fonming rn eats eyrcyeprecusas). Binding acts ne Janus nase Sra Wanscues an acral at vascgben JAKUSTAD snag stay, whch induoes he wanscreton of pts hat abt envy precusor apts ad promt sural. Bing ae aces ‘Sarai ha inreaso he ferent of erytrocie precursors reo mature eyeronss. Tete hes fis nase the reton of certhoces andor celaing red blood el cots. ‘Acting maton facing th JAK? gane ar ascot win pyytema ver, cane myslotlferatve order mare by he carl oieratonof eno eacng o tamati evtons mera) (hole A) Ojo ANP meats te fect ta varity of hamanesincluag ducage, arti homens (V2 eee) and orton, ewer hs away neta rnarynemecsainentrenenes. (rete By ciaiae of marerane prospatpds by phospalpase AZ ads oe maton of accion del, whieh nt ener to prostaglandins an ieuatienes at hop regu the tanec resperca. A vaely cf medestons ect rinecty fect hs tom, Incuing puccartcods nonstrcia arintanraion cs, sdleuctiene Mhbios. (rete D) wee ases merapeut remo a cee a nue recep neu yd Nemene, ams A.D andthe sera hhomones eg guocartcods mneraoconcs, sx hormone) (rete 2) Terzpeutchorranes at cate aplespatajirostl second messenger System clue anti ramon (V1 fect, goratoropitleairghemene, an aoc (rete F} The Rasngen aco potan nase sl Vasco system Seb vat of roth ar (9, epdemal gow, facia, plat med goat, when pean ato stmt cal resto. Unconial acatin of syst can a2eek dt A ee ‘ofeationf entvoces (easing tama leans hemao=®) (hole A) Oj ANP masa ne atte ot avaney ofhomanssincsng gages ars homons V2 cep and comcepn ewer hs away isnt pray nemesiaten entveneness. (hetee B) Clara of marranephespapis by pheshalpase A eds oh maton of arachidonic ac, which intum cervered ita ‘rostagndns ae ection that hob rut the ntanmctor/ response. A val ofmedeatons ect rindecy fect hs tom, incuing coco nonsterida arintrwratoy us, ndlewitiene Phi (hctee D) Wily used rape hemes that active a nude recep nclee yd hemene, amis A 8D, andthe strid hhomones eg auocartcos, mieraocotcds, sex hmong) (rete) Therapextchorranes at chat aplespanajirostl second messenger System clue art remone (Veet, goretoropirleasrg hemene, ané onto (rete F) Te Rasmzgen aca pot nase snl Vasco syst Se by arty of roth att (9, edema ow facta lat dared go ato), whch penny at iat cll rolferaton. Uncontvoled achvatin oft yt can ad 2 maine, Educators ebjective: ‘Oren oney cae conmony associ wth nomocycanoria do redoed pofucion of etrepotn by he ney. Erytropoiin sna arscuton spray esate by he anus krase srl tenses ard acters of Yansctien JAK2STAT) away which ponetes entocre essa sun Reternens + Urea andnestrloyundat: anemia cfcronic key dscase Physcleny ——Hemaagy 8Onedogy Chronic sre disease ra ialOo ar) - wa 5 3e ty bough ote meyer partment ue oa fr aay Te pale vas easteeding wall ts moming, when nebecane ncessingydut io suse, He was tm ube 9a 36 earl mater whohar a sartareaus vagal delvey None. She took preatal amis rauphaut preprany and receives route prenatal are. Hower, te boy dd ntraene ay veccneters rmescatons afer ith de parental peetence for "tua newoom gerd. Family histoysrenakate. Head crcumerence sat the 9h pecetie Weight and length ae athe 25h pecertie.Phyzcleraration hows lage tung ane eniane! The yer pest ven dowrard ae patent ot eo Wa UEwar. No Sab Swing S reser InacanalMemorTage Scrtmed cn head CT scan, Vii of te folowing ithe st aly cave oft infants endo? ©. cermoat mats tagiy OE: impated coin acter eaoration| ra ialOo ar) GB 5 3e ty bough ote meyer partment ue oa fr aay Te pale vas easteeding wall ts moming, when nebecane ncessingydut io suse, He was tm ube 9a 36 earl mater whohar a sartareaus vagal delvey None. She took preatal amis rauphaut preprany and receives route prenatal are. Hower, te boy dd ntraene ay veccneters rmescatons afer ith de parental peetence for "tua newoom gerd. Family histoysrenakate. Head crcumerence sat the 9h pecetie Weight and length ae athe 25h pecertie.Phyzcleraration hows lage tung ane eniane! The yer pest ven dowrard ae patent ot eo Wa UEwar. No Sab Swing S reser InacanalMemorTage Scrtmed cn head CT scan, Vii of te folowing ithe st aly cave oft infants endo? 1A Abst hond tur 6) 1. Sacral menegts (195) ©. Bem ny) 1B. carmnat ma agin (12%) 17: ipared cating fact carry (5%) Omit oe ore escuzza0 lenaton Neonatal vain K efleoy 7 Low warn tres (sor acetal arcfer aris gu ow cola nese mi ra ialLow ann tres (20 acetal YansterSe gu ow content ness mi) + neice vtarn Kueheaten by mate ver [Prerenation| + inrScanal gaeronisiral edaneois unica smal te dng Prevenion |» ineruscier earn Katoh \iovn Kz an zen cada gana gary| coors the ans espera or comeing stay ences ‘atexygtanates. Carole seal fr he tncon of doting fac I tron), VIX and Xs allows othe creation ot Calewmtinding ses. These ses tact he cotng atts to negately charged hassles on pelts and nd cel, rcousing zapton athe formation eany curr ara atu nocd exogenaus warn Ksuplemeraton a endogenas clon basal ra gereates vin Kan Jnstreen vestnes retin vain Kin conta newbome Pave low wean Kore cso peo Yansicera vast now conn eens mic nsficet eves emanate fs mann oe sen ceayesproccon byte acl conan of bate it ire evel ar east uzatonby an mate Ker Necrtl amin Keefer i poveieyadrniaatin of rar amin Kat \Witout erogenous via, asin his patent vain Keene resus in impaired long tetrearboyistion ad these, 3 opens fr leding Intracranial hemorrhage (CH): 3 penal fal campicstion, olen rezting wih nef scan esse (ep ated mena slau, erat head keane Dugg Tanne Souatd ven eyes) (Ghote A) Abusive head Yaura canlead einai Heesrg ad subdralhemoraneininfts. Tiss ess kein ania with ro ‘exenalvauma age an no por amin propyl. Meta ha rceveda vtamin kK mechn ath, bse head ana waa De ‘meres ey dagress (hoiee By Neortal bins mann can present wth thy or inal bl wed patent alec have eur arhypatemin In aon, aca mang oes at piealy ease IoOo ar) GB nr ‘net xogenous vianink, ain i aen, vsmin Keene) resus in impaie clotingftrearboxyistion snd, eer, 2 opens fr bledng, Intracranial hemorrhage (CH) spent aa complain, oten reseriing wih sgn oinreses isc ross. ters mens tatie,elrgnghesdcrumteence lyn onset coer aren ees) (rete A) Atusne eas aura canleadoacanl Desa ao subaalhenorape arts. This sky in tant wh 1 ‘exe vauma ag ano por amin ropa. teat had reed a tami K mecbon ati bus hea aun woud be ‘hermes hie amr (note 8) Neonatal bacteria can present wn ager aby, bt acted plants as ave ero ypaneria Ia ain, ace mening dove at piealy cave ICH. (Chee C) ICH tom bits nutes et coon n operate deers veving vacuo rope ata. Its wn en iis a ypealysymptmane stot te rh ane an at age 1 moat eaten ound 2 wes gestation ard asappeas by uliem Eévetiona objective: ‘amin Kaetoeny ests n mpared cot aca’ carbonation Nesbas ae ako vam K dency due 6 poe vanspacertl trans tan Kandion caret beast ic lnevGors shoud receive vinings prevent Rleengconplcaions References Rien le ose lame Kelsey er yung ans because of arse relia of ops tt + Viin Koen teeing cases Physcleny Hematology 8 Onecogy Varin kdefceney ra ialRC) aes Laue OL) -,yearald woman lh 2 ng str ot manwmoga cones othe pyscanauets 2 ow healed ee deified on route any evan. Shee agoses win fen Gecency anes and tar ono eave sue Ater 3 en of Mea, hearty values have improves. She now aks about topping er soppleart as hes concemed about on bul and aap wa egans. The physician reassures her ang expan that ren hemeosasis' wantaredby mule Woes f cas inte boy. Which fhe loving ces secrete 3 ‘ary rng cle Sone marow naroranes ene nao tem cols Hepatic parenchymal ets Intestinal eptc ra ialOo ar) - wa -,yearald woman lh 2 ng str ot manwmoga cones othe pyscanauets 2 ow healed ee deified on route any evauton.Shels agosed win fen ceicenc nema ad ai one eau suse. Ate 3 es of apy, her abr AES have improves. She now aks about topping er soppleart as hes concemed about on bul and aap wa egans. The physician reassures her ang expan that ren hemeosasis' wantaredby mule Woes f cas inte boy. Which fhe loving ces secrete 3 ‘blancethat cant en serage ad lacey thecal iledin ror homecoaas? ‘A Bay ting eo (05) 8. Boneranew macrophages (18) (©. Boneranow er cts (1%) . YD. Hepatic parenchyma ces (5%) Internal pth cate (17%) F anal nna ots 2%) lotion Hepeicin and body iron regulation ra ialar) GB ‘tannery conte ingeae fe yess esis wie ype an nceaedentvpies acta we ken oes Head !ntuenes nay von aagehough reactant ferportn atarsmenbane pete fesperiiefo Yaron ania Wn he ‘crelaton. Upon tinang pen, eroparin swimalzedans degraded ecessngmesina on absepton and whiting Me lease Kon by macepag Reuatonctinasnal wn zsopton cuca martanirg fen hameostass, since odes sth ol way ot erog ge aren ct ‘ton ome boy. ton been fro fe potinal nal insect bythe dale tal vaneport-1(OMT-1).Once ce the Intestinal cals, on may tke 12 paths 1. on ay no ea (2 pana racer von bean cen) andrenan sexed win the enzrcjte, The stared on sexe n the stool as etry slough of and ar replaced, 2 ion may ero the cicuton tenn feroprin the basalt ron vaneprarfthe enone Feeiten leased he econ transporte eveuhoat ebay by transern(anreninchs anspor pen, which becomes temaized afer meacig wih "arte eco present on leas (Ghote A) Hepciin's secretes rant by hepatica presuce ony 2 ies amount ofhepcn ats manly excrete nthe (Chote B and C) Wen senescent re bb cals are destroyed by macrochapes, th ron reed y the retilenda ye for use inrew enrol precursors. on leased macophapes ude he goveranceof head tines i orate ands dee othe re avo whee etyvlspresusus use a syteaze hemaglba. Ths eal once conses he begs Yn eyelet ny smal aunts of cans eo ate ecu fr daly eal poet ne absence sna bso ss. (Ghote B) Ertecenes sir ton fo exceon inte feces or Yarspat it the cation éepesing on ck eels che pchrpetie hmonehepesin. Lover hepa vl vor on absorption and accumsan nba (Ghote F) Te rena tubular els iy 2 meee nen mezblsm by secre ern whch ins oe Fone wine ard possthy ‘Education objective: esciinis apoypenise synthesize bythe er tat acs asthe cel regulator offen homeostass High ron level and infantry ro ial> Oo ar) - wa 2 tana enter ceding prs, bsnl on taper ce ence Fre Kn release eerste ‘rasp eveupret be body by rast (an rontndng Yanspor pot), which becomes mtamalzed afer erating wth tansfenn eee present on al cots (hetee A) Hepes seco pranly by hepteyes;ilay cele produce ony 2 ited amour ethepcin Batis manly exceed inthe bie (chotesB and) \en senescent ebibod els ate cestyed by mcroohages the ro eyed byte retina ye or use ‘new void precusors. lin eased by macophapes ude the goverance of hepeidn binds ap o vant ands dled othe ‘bone marrow, whee eri precusis use tn syteszehemogcbn. Thisinteral rv cyl consaesthe bed ton very ecient, rd ry smal aroun of ado ton are recited for daly ede routine absence sna boa ss (holes €) Errecys str ton or excreon nafs or vaspar tit the creation depesing on cect els tthe peeps hhomonehepcin. Lover hepsi ls ve Fon absorpon and acct i fe boy (teteeF) The rena iba’ al play a mtd le in en metablm by seg nein, which ind toe kon he wine ard psy recmiere tfor metabo ue Edueaona cbective: Herein is apoypaptseoynescas bythe ner tet oct asthe cent reg ofienhomeostass. High ronevl nina czas nase testes of hepsn ypooa and nreased ervcpoies's att lover Pepin lees. Low hep lees inease intesinaonabsopton ard stmuate Fen lease by macrnhaaes Reternens Physcleny —Hemaaogy 8Oneogy ron defen nema ra ialee Pee og a ‘A Toyeacald ran comes oe oie ues platens. He asf an wep ac fst heathen an mute acabans othe st rar ‘he patennas at nat chest pa, dyspnea, zzness of weakness. Hs medal sly Aclues hypertension an ype? dabels Mes Temperatures 26,7 C (68.1), pulse 102m and requ, ood presse i 40162 mm Hg, and repaton re 18min. Cardoputranay _auscutaton reveals ear ongs acne heart mum. ECG stows an regulary regula htm ih absentP waves, The cates sates on ‘reonlolandapuaban Whefth cling aly oe recy ced a thereat hatha? OA Comers factor x19 © Comersen of frnagen en © © Comers of asminogen plasmin . Comers of rotrontin to tirertin Co ialpe dont A ee ‘A Toyeacald ran comes oe oie ues platens. He asf an wep ac fst heathen an mute acabans othe st rar ‘he patennas at nat chest pa, dyspnea, zzness of weakness. Hs medal sly Aclues hypertension an ype? dabels Mes Temperatures 26,7 C (68.1), pulse 102m and requ, ood presse i 40162 mm Hg, and repaton re 18min. Cardoputranay _auscutaton reveals ear ongs acne heart mum. ECG stows an regulary regula htm ih absentP waves, The cates sates on ‘eon apaaban Whefth cling aly abe recy ced a thereat hatha? ‘A Comrson of face XtoX= 5%) 8. Comers offrrogen to fn 8) ©. Comersin of plasminogen te plasmin (1%) . YO. coment retroinofanin 78) _——— | Sorte i A euee pete ‘Anticoagulants & their mechanism of action Taney] [Bee pay] Co ialSealer ed ail Taney] [Bap] x —» xa Tsue factor m—> ve xe xe ‘Anticoagulants & their mechanism of action Factor Xa inhibitors Direct + Rivaroxaban (or) 1 Rouaban (ora Ingirect + Fondeparinux Deoarne iomink etagenete © Dice womtin inhitiers Car Le Ce [Direct tarombin anions ‘Argatroban | eivatracin (Thrombin) | Dabigatran orl)ar) GB Factor Xa inhibitors Direct + Rivaroxaban (orl) a—- TT): ponctban orl ingrect S"Fondaparinur Bye vvontn isa tora rotors o— ‘ratoban Dheosrn my | Beate Vian Kartagenss crmombny | BSS oe) © bxect enn nto @ Factor Xa inhibitors Fibrinogen ——— Fibrin, ‘agp: nathan of acbn antvonbn Ilha sone Mabon onl china nepuston tre “This pasert has palpation, a nega puis, and ECG nn: consistent watt iliion.Tetment wth arate corto medieaton en, ‘sop! eauces snoveriiniercandiien an ts verre hye hich ps revert sympa fe Fate, zines) ad ‘ekotcardonyopaty,Hnever rte cone spr not ei uncer tal coriaton, 2 ats ean a ak x aa verbs andenbolesteke. Asa rest mest patents ate ao nt cn anteougulaon Dire fctr Xs nhibtors ey apaben) ar cin usd fr stoke preven nl sion ashy ate enter oy and do not requ mantoing ot ra el rl warlann) This dass of medcatons lacks active ate aor Xa, wh event Ha cnvertng ‘rotrembin to tvensin rect tcer anh ar cence hy nrestnatens n'Xaban”ar) GB PE a eee ‘Tas poser has palpi, an agape, and ECG ns canst WP ata MlaonTestnent win arate corte medeaton ep, metopc eouessteventirconduen and ints vere ehycarda, which aps revert pion eg Falter, dizaiess and rskofeaciomopaty. Honever rate can aperts noni unccrinaies aia contacto, s ates emai tr aia verbs Shentolestoke Je arent most paler te alsin on anBeaogulon iret factor Xa inhibtors (ex apiaban are chen used fr stoke pevenon ati aon 35 they a ernst or ado not eave meiting of rua eels (se warn). This dass of mfcatons blocks he aire ste acrXa, which prevents a conven ‘Protrmin to tomb ct fst a IND ae cece by ares thatand "Kaban" (holes A) The comers of face Xt tor Xs the bogring ef conmon pathway ofa coaon cascade adi anered by {aco Vila intnsic athway and sue factor ents patwa), Factor Xa ibs Bleck conversion of pretreat, ntact X (Ghote 8) Far Xa ers ee the conversion cf xinogen fn. However is Sa downstear vet ret) eect hat oes asa (hots ¢) Tesue plasrnenen avian enzyme Pat nceases the conversion cflasnogen © plasmin. is pian Used to Ine ongoing cs patents wih cite ischemic stokes. (hole &) Virsa int tain Kapono estas unchecresestne educa fom ot tami K an ims gamma caron/aton ‘amin X-dependet coaplton actos, I, 1, Education ebective: ‘rect factor Xa hits (9, xan) re atcoaguars ha lckthe act se of fcr Xa which eas to rducedcomersion of ‘rorronbn tren. Ts dass of mesicabonssasminsiered eral and equres no crgievel montonng. Physclony Hematology 8 Onesopy Aa sito Co ialQ zoamin Qzoomou rest GY nado run cartRC) aes Laue OL) ‘A syearcl gis beugitt Me cee tyne eter du soseminl pat and vomang_ The pater as Dawn sraometutnas arse been heat. Abdorialexampaton reveals the Wer 2ige 3 en tele e costal margin and te spleen ip execng paste vel oe unlius. Levozte cuts 104 00%, nd subsequent perpera lod smear evel rumraus Wrghobiasts. The pater s diagnosed win acu hmphetiasevkemaand conan coax cherry i lamed. Which he bung labora changes are mos ely {ote seeninhis pan flowing eaten tan? Porssum Ure acid Phosphorous Lactate terrarogersce 1 ' t 1 1 t 1 1 ial CoOo ar) GB ‘A syearcl gis beugitt Me cee tyne eter du soseminl pat and vomang_ The pater as Dawn sraometutnas arse been heat. Abdorialexampaton reveals the Wer 2ige 3 en tele e costal margin and te spleen ip execng paste vel oe unlius. Levozte cuts 104 00%, nd subsequent perpera lod smear evel rumraus Wrghobiasts. The pater s diagnosed win acu hmphetiasevkemaand conan coax cherry i lamed. Which he bung labora changes are mos ely {ote seeninhis pan flowing eaten tan? Porssum Ure acid Phosphorous Lactate terrarogersce 1 ' t 1 Co ialTumor lysis syndrome Parnes canke ‘ewe lmphoblaetie eum (AL) a ematlee alancy al genera associated wih aah mar call bucen and ape trove a oCu ee Cl es ‘Acuempcblstic eu (AL) a emg malignancy hl genera scsi wih high amar clue and ap trav ‘aie Teele, intaton of jot chevemeapy aeneads 6 massive Ss of ects, wich pls ace cates othe od (ume ae onérome),restirg in flowing + Hyperphosphoten: rac pospaeconcentaten much Nghe an saum pospneelevas. Thee sem phesprate levis typealy spe talowrg chemoteany ination. Because excess pasha s exceed athe nes pallens ar a ke Celcunphoshate deposon ne renal tubules and calectng esta, which cana to hypocalcemia anf ai ra fale + Mypanuteamis: Pune nice acl eases Yom sed une alls re meabeled by annie ousase me lc asc) Beene nea ‘Seed ough the hanes ants par soe paents feat sk stung ui acd nes, hc can aso ace ena ney + Hypenateni: Feassum is pany an rivcelaron Theeve Sgneat anor s gery asccte wth estos of seum potash, wc can ado cada anita, + Eevaedinctat dtyeropenaes L0H) Locate denystogerase a eye neve cea Yspeaton Sains n aves! atruaran els an morn lanai rarer oc calyss face ange of seas aes ep, hemeHec anemia) Level ae Hypealy nteatyelartain ner iy snare Edueatons objective: ater win engi makgrances hathave Nghe cl turers ops uve eat igh kor eco} ebremales foteung the intaton of eto chemsterapy cue oe massive siscfturor cle. Pate’ oreraly develop hperptosphtera, hypekaema,hypensicera ard eevee acae denycronenase Physclony Hematology 8Onesony Tumor hss ssrome: a o