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By M. Randall. Calvin College. 2017.

Dietary triglyceride is a major source (B) Vitamin D concentration of nutrient for the human body benicar 40 mg online. It is (C) Vitamin A (B) An increase in intracellular cAMP digested mostly in the intestinal lumen (D) Vitamin K production by pancreatic lipase to release (E) Vitamin C (C) An increase in intracellular cGMP (A) Lysophosphatidylcholine and fatty 24 benicar 10mg amex. Which vitamin is transported in production acids chylomicrons as an ester? When the pH of the stomach lumen diglyceride (E) Vitamin B12 falls below 3, the antrum of the 19. Potassium is absorbed in the jejunum stomach releases a peptide that acts absorbed by the small intestine and by locally to inhibit gastrin release. This transported in the lymph mainly as (A) Active transport peptide is (A) VLDLs (B) Facilitated transport (A) Enterogastrone (B) Free fatty acids bound to albumin (C) Passive transport (B) Intrinsic factor (C) Chylomicrons (D) Active and passive transport (C) Secretin (D) LDLs (E) Coupling to sodium absorption (D) Somatostatin (E) HDLs 26. Which hormone stimulates pancreatic autosomal recessive disorder involving (A) Enhances the absorption of heme secretion that is rich in bicarbonate? Feeding dipeptides and oxygenase (C) CCK tripeptides containing tryptophan to (C) Is a reducing agent, thereby (D) Gastrin patients with this disease improves helping to keep iron in the ferrous (E) Insulin their clinical condition because state 14. A patient suffering from Zollinger- (A) Dipeptides and tripeptides, unlike (D) Decreases the production of Ellison syndrome would be expected to free amino acids, can be taken up ferritin by enterocytes have passively by enterocytes in the small (E) Stimulates production of (A) Excessive acid reflux into the intestine transferrin esophagus, resulting in esophagitis (B) Peptides, unlike free amino acids, (B) Excessive secretion of CCK, can be taken up by defective amino SUGGESTED READING causing continuous contraction of the acid transporters Alpers DH. Digestion and absorption of gallbladder (C) Dipeptides and tripeptides use carbohydrates and proteins. In: John- (C) A gastrin-secreting tumor of the transporters that are different from the son LR, ed. Physiology of the Gastroin- pancreas, causing excessive stomach defective amino acid transporters testinal Tract. New York: acid secretion and peptic ulcers (D) The presence of dipeptides and Raven, 1994;1723–1749. Hepatic trans- failure of the liver to secrete VLDLs enhances the uptake of amino acids by port systems regulating pH, cell vol- (E) Inadequate secretion of bicarbonate the transporters ume and bile secretion. Annu Rev by the pancreas (E) Dipeptides and tripeptides, unlike Physiol 1992;54:415–438. Lactase is a brush border enzyme amino acids, can be taken up passively Choudari CP, Lehman GA, Sherman S.

Bowman’s capsule: from Sir William Bowman cheap 10mg benicar, English anatomist buy 40 mg benicar visa, 1816–92 Glomerular capsule Efferent glomerular arteriole Afferent glomerular arteriole FIGURE 19. Urinary System © The McGraw−Hill Anatomy, Sixth Edition Body Companies, 2001 Chapter 19 Urinary System 681 Afferent glomerular arteriole Efferent glomerular arteriole Blood flow Primary process Capillary Blood flow endothelium Pedicel Glomerulus Fenestrae External wall of glomerular capsule Filtration Proximal convoluted tubule Podocyte Slit pores Internal wall of Loechel (a) glomerular capsule Slit pore Pedicel Primary process of podocyte Glomerulus (b) FIGURE 19. Note that the diameter of the efferent glomerular arteriole carrying blood away from the glomerulus is smaller than that of the afferent glomerular arteri- ole transporting blood into the glomerulus. This is one of the contributing factors in the maintenance of high blood pressure within the glomerulus. The first step of urine formation is the filtration through the glomerular membrane (arrows) into the glomerular space of the glomerular capsule. Urinary System © The McGraw−Hill Anatomy, Sixth Edition Body Companies, 2001 682 Unit 6 Maintenance of the Body Pedicels Slit pores Basement membrane Capillary lumen Fenestra (a) (b) FIGURE 19. The filtrate then passes across the basement mem- brane and through slit pores between the pedicels and enters the capsular space. From here, the filtrate is transported to the lumen of the proxi- mal convoluted tubule (see fig. The inner layer of the glomerular capsule is composed of proximal convoluted tubule and has fewer microvilli. Passing through the renal digitate, like the fingers of clasped hands, as they wrap around papilla, the papillary ducts empty fluid into the minor calyx, the glomerular capillaries (figs. Once within the ca- pores between adjacent pedicels provide the passageways lyces, this fluid is known as urine. From the major calyces, urine through which filtered molecules must pass to enter the interior collects in the renal pelvis before it passes from the kidney into of the glomerular capsule. Filtrate in the glomerular capsule passes into the lumen of Two principal types of nephrons are classified according to the proximal convoluted tubule. The wall of the proximal con- their positions in the kidney and the lengths of their nephron voluted tubule consists of a single layer of cuboidal cells contain- loops. In the process of reabsorption, salt, water, and nephrons—have longer loops than the cortical nephrons that other molecules needed by the body are transported from the have their glomeruli in the outer two-thirds of the renal cortex lumen through the tubular cells and into the surrounding per- (fig. The kidneys have an autonomic nerve supply derived from The glomerulus, glomerular capsule, and proximal convo- the renal plexus of the tenth, eleventh, and twelfth thoracic luted tubule are located in the renal cortex. Sympathetic stimulation of the renal plexus produces a proximal convoluted tubule to the nephron loop (loop of vasomotor vascular network response in the kidney. This fluid is carried into the renal medulla in the de- sponse determines the circulation of the blood by regulating the scending limb of the nephron loop and returns to the renal cor- diameters of arterioles.

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Vitamin D deficiency in the vation or chronic ill health) cheap benicar 40mg visa, radiological features of rick- adult skeleton results in osteomalacia purchase 10mg benicar otc, the pathognomon- ets may not be evident at the growth plate. In rickets of ic radiographic feature of which is Looser’s zone, named prematurity, little abnormality may be present at the after E. However, the bones are osteopenic and are translucent areas in the bone that are composed prone to fractures. They are typically bi- diographic features of rickets may only become apparent lateral and symmetrical. Radiographically, they appear at puberty, during the growth spurt, with the metaphyseal as radiolucent lines that are perpendicular to the bone abnormalities predominating at the knee. Looser’s zones can occur in any bone, but most typ- provement in biochemical parameters (2 weeks) and clin- ically are found in the medial aspect of the femoral neck, ical symptoms. With treatment, the zone of provisional the pubic rami, the lateral border of the scapula, and the calcification will mineralize. They may involve the first and second ribs, in rated by translucent osteoid from the shaft of the bone which traumatic fractures are uncommon, being usually and may be mistaken for a metaphyseal fracture of child associated with severe trauma. Reduced bone density and poor definition of for Looser’s zones are the metatarsals and metacarpals, epiphyses are helpful distinguishing features for rickets. They may not The section of abnormal bone following healing of rick- always be visible on radiographs; radionuclide bone ets may be visible for a period of time, and give some in- scans are more sensitive in identifying radiographic oc- dication as to the age of onset and duration of the period cult Looser’s zones. Eventually, this zone will become indistin- Looser’s zones must be differentiated from insuffi- guishable from normal bone with remodeling over a pe- ciency fractures that can occur in osteoporotic bone, riod of 3 to 4 months. The zone of provisional calcifica- particularly in the pubic rami, sacrum, and calcaneus. Incremental fractures oc- for rickets and can occur in any condition (i. There will be evidence of retarded growth and development in rickets, but in my experience this tends to be more marked when the vitamin D deficiency is associated with chronic diseases that reduce calorie in- take, general well-being, and activity (i. In an attempt to maintain calcium homeostasis, the parathyroid glands are stimulated to secrete PTH. This re- sults in another important feature of vitamin D deficien- cy rickets.

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By M. Randall. Calvin College. 2017.

Dietary triglyceride is a major source (B) Vitamin D concentration of nutrient for the human body benicar 40 mg online. It is (C) Vitamin A (B) An increase in intracellular cAMP digested mostly in the intestinal lumen (D) Vitamin K production by pancreatic lipase to release (E) Vitamin C (C) An increase in intracellular cGMP (A) Lysophosphatidylcholine and fatty 24 benicar 10mg amex. Which vitamin is transported in production acids chylomicrons as an ester? When the pH of the stomach lumen diglyceride (E) Vitamin B12 falls below 3, the antrum of the 19. Potassium is absorbed in the jejunum stomach releases a peptide that acts absorbed by the small intestine and by locally to inhibit gastrin release. This transported in the lymph mainly as (A) Active transport peptide is (A) VLDLs (B) Facilitated transport (A) Enterogastrone (B) Free fatty acids bound to albumin (C) Passive transport (B) Intrinsic factor (C) Chylomicrons (D) Active and passive transport (C) Secretin (D) LDLs (E) Coupling to sodium absorption (D) Somatostatin (E) HDLs 26. Which hormone stimulates pancreatic autosomal recessive disorder involving (A) Enhances the absorption of heme secretion that is rich in bicarbonate? Feeding dipeptides and oxygenase (C) CCK tripeptides containing tryptophan to (C) Is a reducing agent, thereby (D) Gastrin patients with this disease improves helping to keep iron in the ferrous (E) Insulin their clinical condition because state 14. A patient suffering from Zollinger- (A) Dipeptides and tripeptides, unlike (D) Decreases the production of Ellison syndrome would be expected to free amino acids, can be taken up ferritin by enterocytes have passively by enterocytes in the small (E) Stimulates production of (A) Excessive acid reflux into the intestine transferrin esophagus, resulting in esophagitis (B) Peptides, unlike free amino acids, (B) Excessive secretion of CCK, can be taken up by defective amino SUGGESTED READING causing continuous contraction of the acid transporters Alpers DH. Digestion and absorption of gallbladder (C) Dipeptides and tripeptides use carbohydrates and proteins. In: John- (C) A gastrin-secreting tumor of the transporters that are different from the son LR, ed. Physiology of the Gastroin- pancreas, causing excessive stomach defective amino acid transporters testinal Tract. New York: acid secretion and peptic ulcers (D) The presence of dipeptides and Raven, 1994;1723–1749. Hepatic trans- failure of the liver to secrete VLDLs enhances the uptake of amino acids by port systems regulating pH, cell vol- (E) Inadequate secretion of bicarbonate the transporters ume and bile secretion. Annu Rev by the pancreas (E) Dipeptides and tripeptides, unlike Physiol 1992;54:415–438. Lactase is a brush border enzyme amino acids, can be taken up passively Choudari CP, Lehman GA, Sherman S.

Bowman’s capsule: from Sir William Bowman cheap 10mg benicar, English anatomist buy 40 mg benicar visa, 1816–92 Glomerular capsule Efferent glomerular arteriole Afferent glomerular arteriole FIGURE 19. Urinary System © The McGraw−Hill Anatomy, Sixth Edition Body Companies, 2001 Chapter 19 Urinary System 681 Afferent glomerular arteriole Efferent glomerular arteriole Blood flow Primary process Capillary Blood flow endothelium Pedicel Glomerulus Fenestrae External wall of glomerular capsule Filtration Proximal convoluted tubule Podocyte Slit pores Internal wall of Loechel (a) glomerular capsule Slit pore Pedicel Primary process of podocyte Glomerulus (b) FIGURE 19. Note that the diameter of the efferent glomerular arteriole carrying blood away from the glomerulus is smaller than that of the afferent glomerular arteri- ole transporting blood into the glomerulus. This is one of the contributing factors in the maintenance of high blood pressure within the glomerulus. The first step of urine formation is the filtration through the glomerular membrane (arrows) into the glomerular space of the glomerular capsule. Urinary System © The McGraw−Hill Anatomy, Sixth Edition Body Companies, 2001 682 Unit 6 Maintenance of the Body Pedicels Slit pores Basement membrane Capillary lumen Fenestra (a) (b) FIGURE 19. The filtrate then passes across the basement mem- brane and through slit pores between the pedicels and enters the capsular space. From here, the filtrate is transported to the lumen of the proxi- mal convoluted tubule (see fig. The inner layer of the glomerular capsule is composed of proximal convoluted tubule and has fewer microvilli. Passing through the renal digitate, like the fingers of clasped hands, as they wrap around papilla, the papillary ducts empty fluid into the minor calyx, the glomerular capillaries (figs. Once within the ca- pores between adjacent pedicels provide the passageways lyces, this fluid is known as urine. From the major calyces, urine through which filtered molecules must pass to enter the interior collects in the renal pelvis before it passes from the kidney into of the glomerular capsule. Filtrate in the glomerular capsule passes into the lumen of Two principal types of nephrons are classified according to the proximal convoluted tubule. The wall of the proximal con- their positions in the kidney and the lengths of their nephron voluted tubule consists of a single layer of cuboidal cells contain- loops. In the process of reabsorption, salt, water, and nephrons—have longer loops than the cortical nephrons that other molecules needed by the body are transported from the have their glomeruli in the outer two-thirds of the renal cortex lumen through the tubular cells and into the surrounding per- (fig. The kidneys have an autonomic nerve supply derived from The glomerulus, glomerular capsule, and proximal convo- the renal plexus of the tenth, eleventh, and twelfth thoracic luted tubule are located in the renal cortex. Sympathetic stimulation of the renal plexus produces a proximal convoluted tubule to the nephron loop (loop of vasomotor vascular network response in the kidney. This fluid is carried into the renal medulla in the de- sponse determines the circulation of the blood by regulating the scending limb of the nephron loop and returns to the renal cor- diameters of arterioles.

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Vitamin D deficiency in the vation or chronic ill health) cheap benicar 40mg visa, radiological features of rick- adult skeleton results in osteomalacia purchase 10mg benicar otc, the pathognomon- ets may not be evident at the growth plate. In rickets of ic radiographic feature of which is Looser’s zone, named prematurity, little abnormality may be present at the after E. However, the bones are osteopenic and are translucent areas in the bone that are composed prone to fractures. They are typically bi- diographic features of rickets may only become apparent lateral and symmetrical. Radiographically, they appear at puberty, during the growth spurt, with the metaphyseal as radiolucent lines that are perpendicular to the bone abnormalities predominating at the knee. Looser’s zones can occur in any bone, but most typ- provement in biochemical parameters (2 weeks) and clin- ically are found in the medial aspect of the femoral neck, ical symptoms. With treatment, the zone of provisional the pubic rami, the lateral border of the scapula, and the calcification will mineralize. They may involve the first and second ribs, in rated by translucent osteoid from the shaft of the bone which traumatic fractures are uncommon, being usually and may be mistaken for a metaphyseal fracture of child associated with severe trauma. Reduced bone density and poor definition of for Looser’s zones are the metatarsals and metacarpals, epiphyses are helpful distinguishing features for rickets. They may not The section of abnormal bone following healing of rick- always be visible on radiographs; radionuclide bone ets may be visible for a period of time, and give some in- scans are more sensitive in identifying radiographic oc- dication as to the age of onset and duration of the period cult Looser’s zones. Eventually, this zone will become indistin- Looser’s zones must be differentiated from insuffi- guishable from normal bone with remodeling over a pe- ciency fractures that can occur in osteoporotic bone, riod of 3 to 4 months. The zone of provisional calcifica- particularly in the pubic rami, sacrum, and calcaneus. Incremental fractures oc- for rickets and can occur in any condition (i. There will be evidence of retarded growth and development in rickets, but in my experience this tends to be more marked when the vitamin D deficiency is associated with chronic diseases that reduce calorie in- take, general well-being, and activity (i. In an attempt to maintain calcium homeostasis, the parathyroid glands are stimulated to secrete PTH. This re- sults in another important feature of vitamin D deficien- cy rickets.

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Only by understanding an individ- thetical and not based on any specific case ual’s total experience with chronic illness or individual buy discount benicar 20mg on line. The focus tle prior medical knowledge but who work of the book is to help professionals and with individuals with chronic illness and students understand medical and psycho- disability and need to have an understand- social aspects of chronic illness and dis- ing of medical conditions trusted benicar 20mg, their implica- ability and how they affect an individual’s tions, and need to have an understanding functioning in all areas of life, including of medical terms. It is designed as a refer- psychological and social impact, impact ence book for professionals in the field as on activities of daily living, and on voca- well as a textbook for students. Individuals with chronic ill- The impact of chronic illness and dis- ness or disability who do not fit the socially ability is far-reaching, extending beyond determined norm may find that, regard- the individual to all those with whom the less of their strengths and abilities, they individual has contact. Chronic illness continue to be regarded in the context of and disability affect all facets of life, societal views rather than their own. Consequently, one the extent of impact, every chronic illness must consider the effect of the diagnosis, or disability requires some alteration and symptoms, and treatment on all aspects of adjustment in daily life. The extent of individuals’ lives, specifically on their impact is dependent on: capacity to function within their environ- ment. It also includes sig- sonality nificant events and relationships with • the meaning of the illness or disabil- family, friends, employers, and casual ac- ity to individuals quaintances. No relationship exists in iso- • individuals’ current life circumstances lation. Just as individuals’ reactions to • the degree of family and social sup- illness or disability influence the reactions port of others, so the reactions of others affect Reactions to chronic illness and disabil- individuals’ self-concept and perception of ity vary considerably. Social groups establish their As interactions or capacities change, or as 1 2 CHAPTER 1 PSYCHOSOCIAL AND FUNCTIONAL ASPECTS OF CHRONIC ILLNESS AND DISABILITY they become limited or restricted, roles ed toward meeting specific needs (Shaw, and relationships also change. There some changes and adjustments may be must be an understanding of individuals’ made with relative ease, others can have strengths, resources, and abilities as well repercussions in many areas of daily life. DISEASE AND ILLNESS Acute refers to the sudden onset of symp- toms that are short term and that incapac- Words are powerful conveyers of con- itate individuals for only a short time. Using a standard def- Chronic refers to symptoms that last inition of terms facilitates communication indefinitely and that have a cause that and understanding of what each term may or may not be identifiable. The term disease is derived from ditions that begin acutely but are not the medical model, which refers to changes resolved become ongoing and chronic.

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Total customer reviews: 338