idD aenoyn eden to arde atht alts sncteene leik 05 eitsm auseecb eht htroau efruses to seu eretbt g.rramam stJu .sgrtnuatfir
hTe cnpteco si a vdcuoeontl awy of nigkas fi ouy wken ohw DVJ inaoroteibcnm rskwo, cwhhi is ttah ti si aualtcly an eplemxa of erialtng the NDA fo hte BT/ ceyhtlmop.y
hternuoS ltbo uhi:etcenq oS ehwn etyh sue a erobp iagtsna meso nigoer, and ogtnutupti a zsie fo .51 kb ro 6 b,k htsi si ginllte oyu hte szei of eht ADN tmefagnr ni eahc clle sdnte(oβ trmaet fi hety asy J rpebo or ttcaosnn rinego eb,rop hyeretβ sujt sgiyna rehtyeβ gtnegirat seom lndueitceo sqecneue nfuod in teh gI oC/TlRucs btea cnaih scluo teipcversely for B/T .ce)lsl
I thnik teh uisogncfn prat locud eb ndoegnriw how uoy nowk ehthwer yuroeβ ryplta ohhurgt mreaenegnratr e(awnsr cicehso B rtuh D) ro if it tnβahs recdrcuo ta lal tey tecrrc(o .ean)swr ,reeH het cnpocet si that B lscle rgenoud )D(JV tamenagernrre ni hte boen m,owarr lhewi T elscl do ti ni teh hmtusy, and it lla asphenp ta noc.e oS a paamsl lecl in eth dobol ekil in lupMelti Mmeyloa dlwou vhea uflly enurednog ,einoitcormabn liweh a T ecll ni eth boodl oudcl rhetei be fylul eeutcadd dn(a have siedinhf VDJ oobmreinncat)i or timeaurm (ntaβhs tdrates )JV.D
cienS the T lecl nege aws 6 bk nad efltyniied gbrgei htan hte 15. kb neeg, teh T clle htsaβn oegenrudn nmrenoioibcat yte.
Wcihh of teh olilwongf oranses is ywh isth qitosneu is ul?lb
1) niUsg eth wrod "lciy"cc sienatd of lyccictir rfo aitclry
)2 nwinKgo all of megliopyoied fo lla urdgs
)3 avgihn to nseaor uot taht irticlegocnanhi efestcf aer brbaypol eth rtwos evro aph1la or H1 teefscf to on etc.rantyi
4) hTe irngppicl noesrepdis of dtnysgui orf aey-ewo-tsdks on nde to yrblapbo do vaeager no het ts.te
sihT noe asw a litlet y.tirkc For sith oen the yek is eth owl oedioridnia pa.tuke iTsh tatpeni sha hihg T4 nad wol THS hwcih kmesa sense ni a ohydyprerhti intteap, ashrpep oyru rifts gohutht is ttha shti nattpei has βeGarvs deessia. rvowHee, ni aeGβsrv uyro yiohdtr si eigbn etulistamd to keam meor tordyhi enomorh frmo acrcsth and as uhcs doluw aehv na erescandi idooarindie paktue uaebesc eht yidthor si nibnggri ni hte irreeqdu ow(n edlbedl)riaoa dinoi.e Tshi is yhw it si not easvGr sereel(βa of dyhtiro mheoonr orfm a dtyihro smeatitdlu yb datoeb)niis.β
oS fi ist ont vsreβaG atwh clduo it eb? For sthi uydoβ hvea ot onwk ahtt iβstsoamHoh iiihsdyTrot as(lo okwnn sa hCcorin omycctyipLh siyToirdhti nda is oetfn ererfred to as chsu no abrod esmax ot hwrto oyu o)ff hsa rhete aeshsp - tsrfi heyt ear ,derirphytohy tnhe odyetruih, ehtn het cslcais oopythyhdri thta uoy wluod exetcp ihtw low T4 and hgih TSH. shiT wsa teh yek ot stih qnto.ieus The oensra rfo htis si htta itthnyirdao reioedpxsa oesitdianb in istsoomβahH ceusa hte ihdotyr to aelseer lal fo tis rodtse rdyhtoi orenmho gimank teh inpteat tyrrydhepiho rfo a sthro doreip fo t.eim Aeftr hsti emaisvs leeraes of iyrdtho oomh,ern het obdtaeniis akem htem anbule ot maek wne HT dna erforehte eyht mbecoe youietrhd for a sohtr irodpe adn tnhe iohpyrdotyh whihc oyu duwol tee!pcx cinSe thye βantc meka wen T,H the droiyth ilwl nto tkae pu teh idrneooaiid dna treeehrfo rheet wlli be low odriidenoai .ueaktp ne,Hce βslereae of tersod rthdoyi horoemn fmro a ydhirot dnlga irettlfndai yb lmβsyyoept.hc aka hpoyLiβmyctc assom)(hhito hrotid.yitβsi
I tkinh βeslerea fo yotrdih ohronme mfro a tpmhlmouoyas horiytd dβnagl si egirrernf to omes knid of tyrdhio neccra ni hhciw saec uyo dlowu pcxtee meth to be esnrbiidgc a eludon on raidiooeind keutap.
mβaSuyrm divoe hree dna soal a eatgr itse ni eraln:ge aaimtethtr/dh/dlsoorp/en/e:/ueondyceireiinrspo.q/ncdg
hiTs eimag si eulusf. toNe hatt the insta sude emska inmely apaerp kdra.
eettiVng is ctiapyl for srn'iPsknao sadiee.s eraA D si teh usabstnait a.rgni
noNiegtr cablnea si a masenetrmue fo trpieon oiestblamm in the byd.o A nvgeieat ntrniego cnlbaae nsctdiaei sluecm l,oss as ricdesaen touasmn fo onima cdsai are iegbn bteeolazimd to pdcroue gyrene. Tihs cesnriase the uontam fo negritno resedetc mfro eth yod.b uBacees eht toaumn fo erotingn oyu ear inkgat in si sles anth eth uaotnm fo inerntgo uoy are rscingete, uoy veah a egatnvei rgntnioe abaecnl.
hTsi nam si ,domniualsreh ,mesuodate ce,chacti nda sha pbaiyimol.umaehn eTesh illcainc giidnsnf iotnp to tepinor ilritaomnnut rws(hkiaKao Desisa)e, whihc asucse meade due ot seaeedrcd esrmu niotcoc erruepss. Lwo ncociot sserpuer ni tsih csae si deu ot ieotrnp loss, adn henec a etnaveig oignnret nel.acba
iLke htrose eahv asd,i I tnkih notuiiabsml uoldw aehv bnee eter,tb ubt cileemdnatsp fmor ifsrt ida sasy atth ti is, tenriiroβecd fo moiensto ro seliumps ot a lnuater sronpe or coetbjβ os βhses iikkcgn her mailyf yb ginkkci eht a.gb
h"es selef ieaphpr nda orme e"edlrxa fatre atsgrtin ckkni:igxbo tshi si a ERAUTM eeensdf smmehinca scs(acil boxktteo tsluoaiibmn, as ash been sad.)i shTi ntuisoeq is tsju inapl .rgnow Ist' tno espdmc,tlenia ebuacse 'tsi a h,hetlya lsciloay etbcaelacp ttleou hatt premiosv erh taloomien tse;at nighncup absg era amnet to eb euhcdnp ht(us it si cuyatlal ONT atu)re.nl lateinceDpsm ot na ojtecb uodwl be cngunihp a oleh ni reh ,awll ro gbinrkea ehr vsea (I tujs ekli that iyrag)m.e Both fo hseot uwlod eb ttrbee tanh ciuhgpnn her ymaif,l ro knaergib rieth arc wiw,ndo hhcwi si ywh sit' csetapdnmlei non(scicouus oceiinrdtre of na oetmoin to a afsre je).ctob ,evHerow ckxgnkiobi is ETALIRLLY an aelxepm ni realesv sypch bxttkoseo rfo siitbln.uaom nhkaT oyu ofr ocignm to my ETD .lkTa
I tnikh tis het gihrt MLF ae(ar )C, not teh grhti dscabuen uenlucs that si eedisoln on teh csros e.cistno fI eht dnscbaeu nucsuel erwe lseeoind ehs twlo'dnu vaeh dntaobicu ni her eltf ey.e The LMF etedmais sscor alkt eeebwnt hte sbcuneda luesunc on obht isdse ot the FML no the ppsitooe iesd 2( ensbduca luice,n 2 MFL neo no eahc e.is)d nI reh a,cse erh igtrh MLF 'tsnwa ncungtoniif eechn why esh asw znigga letf ubt ehr tgrih midedl etrcsu s'awnt atcinonctg ot eemaidt edawftrl aeg.z
hsiT prieuct p:lseh 2pw09Fmo:pttnpe/htw.h2ahcdhomnt.c/u/1gs-no-ou4w-/1t5a/jtb/thpp_eml0/w
asicColalutn fro dda. hTe btailpiboyr of the efhtar iebng a arrirec is /32 icsen it si onwkn htat he tnedosβ aveh hte ieses.ad enhT eth irltpbybioa fo imh snpsiag ti no to ish kdi si 1,2/ t:hus
Cuclslonaita ofr omm. ihWt eth rebdyeagHirWn- ciln,prieP yuo anc eufigr tou eth ryiilbbtpoa fo hte omtreh bngie a eirrrc:a
q = /t0r1q4)s(0,00 = 20/10
,So pq2 = 2 * 01/20 * 929010/, hwhic si aopxrp 001/.1
orF eht ldhic to teg the elleal fomr o,mm wto htgnsi eden ot eh:pnpa (1) omm mstu eb a rerarci eezyoeβhgr]βt[ot dan 2() mmo smut spas het elalle to ih:dcl
tnPiug it all reghetot. w,oN enmiocb lal eehgrtot:
= riilotbyapb( fo add niebg aecrirr) * lb(rtaypiboi fo dad gainssp no ssaeied )eallle * (ylbtiirapbo of mmo ngibe rrci)rae * bly(taiirbpo of mmo sigsapn on saesdie eaelll)
= /32 * 1/2 * 01/01 * 1/2
=
1 ni 060
uto of uiytcsio,r who mya eppleo ewkn hts?i todn( eb hsy ot say yuo idd ro ?dndti)
yM eyrpvot nuceiodta 'nidtd grnanii thsi ni me.
iHs iatdl eovlmu swa 500 mL. dxra-pEryineot wsa 5+ cm dan sipotnraniryed- was 52+. eW rwee pedssoup to sue het cdfieenerf ni ayiawr re,rpuses dna otn hte r-ynratdpneisoi peulrla ersserpu 2)(+.0
camlnCiope = VPΞΞ/ = 050 / 02 = 25 Lmm/c 2OH
roF eht espep woh got fcuosdne on tihs qusetoin cb fo lod'rUsW deiwr iesqtuon no IHV vilra dl:ao
cueat 1H-VI etinc:info HGHI ivral d,alo wlo -2IAbH V noecfi:tin WOL irlva ao,dl wol bA cb( astdrand IVH sayass tdceet 2,4p chihw is ton pesrent on H-)I2V
dKina ynnoead I issmde an aeys ingomoulmy oncectp onuisqte :/
eTh ndrisicoept of alibretal rewol mbil olss fo ivrtaboin mepisil MLCD dea,gam and het aebsnt DRTs + rbmeoRg esme to me ot eb mignyilp htta eh psbsylio ahs ebsat adssiolr mofr isshypil (or tsnhegomi reyv irmalis ni ot.rne)iesaptn
sA for teh otrhe waensrs, A si grnow ubcseea ish trmoo noitcnuf si a,ictnt B si nrwgo ecesbua inpa nad tartreuemep stefidci rae not nteoid,mne C is gowrn becesau it spiilme a eicspfic vreen is eertdna,pp tbu he has lsot batilrela tsoenaisn in ihs neietr lwore xiiesretmte
D si eth it,tiscker nad Iβm otn 100% esu,r ubt I wudlo ntikh optlaicdahyur fo het trenoria nvl)tear( tsoro oudwl eusac omtor icefisdt ncise tyhe raycr mtoro feters.fen ouY ihgmt osal texpce atht rtoom cosdufytnni to eb rilne,luaat enisc it dwulo eb unkliyel ot haev a mprbeol tihw het revne sroot on obht sdsei. laso the LMDC si nto alcdteo arne het tinoarer ortso of hte aslpni odr,c so fi eht reitroan rosot wree adteecff uyo lraely wβdontlu petxce to ese oabrtyvir .lsos
So alasblicy oesrcsp fo ie,olitnamni I do eelf ekli nysores toyphernau si an reexleytm aeugv sawrne oughht nda I watsnβ a afn fo eht eituqso.n
nI ooli,ybg aheps onritviaa is a omedht for elngiad ihwt daiyplr vyragni mtnsvieenron oittwuh neiirrguq darmno tuitno.ma It losevniv hte ranaiotvi fo piteorn sx,peoeisnr tuyenlefqr in an fn-oof nohfsi,a whtini idnefetfr rpsta of a clareitba a.tpnpoiuol As hucs the enephpyot cna swtchi ta feuiqncerse thta are cmhu hhegri mmstseoei( ;1)gt&% anth icsallcas omtunita .eatsr haePs rvnaiioat ustobrenict to lrucieevn by gnantiegre itreteegnh.oey utohhAlg ti has eneb tsmo nlmmocyo ddtiesu in eht totexnc of euimnm onaesi,v it si eeovdsbr in yman rtoeh aaser as elwl dna is lypeeodm by uviosar typse of aaci,etrb cuigdnnli alSloamenl e.iscpes
rAsw:ne aecrIneds ltneCar dlooB Voleum ,CVB() receaDsde HAD, adIsecner PAN.
heT oyallgisiophc psorense ot omhytapheir is sisornncctovaiot fo eepplhirra vsslsee e(i.. teh nseo in uryo it)iseertemx ni na foetrf to epke oyur eroc bdoy erumaeetptr oanlrm, dan huts oyur argnos oinnnctgfui .propeyrl rreielpahP ootisVoantcnsirc ilwl icrsnaee CVB. Idsneearc VBC llwi ceuas na saienrec ni oaple,dr nda uhst suaec na erincaes in NPPNBA/. NAPP/NB sah iirynhboti esfftce no the -irgdAie-nnssteionnAnloeRtone yem,Sst inrteusgl ni edeesdcar DHA.
Jsut brreme:em
)1 tetT-s eta( rfo wo)t = skool at teh mnea lauves of 2 urgosp
2) NAVOA ynsaisl(a of eviac)arn ~ like -settt tbu = lskoo at mnea euaslv fo 3 or ermo opugsr
)3 ehaqri-usC = slkoo at eht %() ro ooornipptsr ewnetbe 2 or oemr .psugro
,so usjt okol fro woh mnya sprogu benig sadeedrds adn thwa leavsu htye rae inugs (% ro nme)as
hiTs si a anetitp csea fo toutmspapr dyi.ttisroih nCa risae pu ot a raey rfeat yiedlrve adn ash mcictyohpyl nrlifei.tta
heT raohuts ntew tou fo rehti ywa ot nfid thew orstw thopo of a nogmaarlu hety udoc.l Teh erhwt no a smet ttah eggstssu ttah ti ulodw be nturlginaoa .siuet uBt eitllt ddi we .o..knw
my islt of denslip tyep lslec dna idctnnsi:oo
Jsut my tow ets:cn y,bhatrotCoptlso myirapr tsem lusl,iv anpbo,olristcyhtysot and hpibttolscrao ulceaan aer lal oecsomnnpt of the dnoeglvpie pectnaal, which speluspi teh fesut ni orue.t hseeT ustrrtcesu era all edevrid fmro the oarsl,btptoh wihhc si orddceenis bcemi-nxatoeryr stse.ui epo"Hecmiitoat tesm esl"lc si hte ylon sweanr cicheo taht uwold aeicdnit aflet saptr ewre .oredfm
leuyhhel.suryTuopsorblb/:p//oegmeagxddmwate.p/otn.hi/oynp.styob.mdr
I ihknt talo of epolpe tmihg haev oerv dhpzsmeiea owh ttaimornp PAN dan NBP lealyr r,ea yse it si tprotmina ot wokn eshte eippetds tge sredecte by eth cni/eaavaritrtllur oiamdyrcum gnuird etrah urf.ilae Heoevrw heitr reaollv estcvifeensef in tatgnrei aerth eliafru is ,zhlci a rpepercot dotl me ttha if APN dan NBP reew so uelusf in atiiernrsus enht ywh do ew evig iierc?dust tIs' seuabce ASRA poeeosrrwv thsi semsty nheec incsuga ievateng fetsfec nda eht elessdn loop fo atreh feraui.l AKA wyh ew giev CAE tioin.sbirh
gwinnoK ttah APN steg znaidlerteu by het RAAS ,eysmst we nac shtif uro oufsc kbca ot rheta leaiufr in ihts einpa,tt hrwee circdaa tptuuo is dare,dscee idlnage to HDA tirncoese dna afyinll uadiiloltn eriahpn.omtay
FA 5.p74 - ungibrn urbbre lemsl iihloulncanat uocscr as an arau ofr lmeparot ebol iypplese
sosl fo udlfi tisrrgeg dletoensora rdnoticuo,p os ettpian will heav amhnirrtpaeey dan iamykhealpo as a lutres
iAtreanlto of eht amhticosttre est npoit si a hmihycptlaoa rscsepo taemdide by alisdnoptasgrn and si denpdnnitee fo het sicapyttmhe uesnvor tmessy.
B, C, ,D dan E lla reeriuq tamhysetpci rvnsee to cteilil a .eprsosne
Fgenri nloxief oden :yb
_
:aIrnveointn
_
rOu anpteit catn' xlfe IDP fo girn rgnife β P4FD β urnla β .T8C-1
Oynl bspsolie sewrna ew anc ckip si 8C.
reonMphi is taebedimzlo ni teh virel ot poiredmc-nh6ugroel-nui and -lmiinn3roe,opgru-ehcdu tohb fo hiwhc rae etcredxe yb teh nksd.iye In teh ttsngie of alner ufeia,rl ehets tlaoetmibse nca umcelcaatu, ritueglns in a lgewonri fo eth zeriues lrsthe.doh poihreMn dhluos rerhfteeo eb uesd hwti coatuin ihtw midl ealrn atniremipm dan be dvioaed in the gintets fo areln uali.rfe
yhte egva a hnti fo ricedesna eictiannre le,vel ulps dorle gea can vgei a lsdwoe down abseimmtlo dna NCS yopmssmt
ieeDspt a umrneic elvua ldo(ob eersr)usp enigb edmesuar, tsaipnte udwlo eb stdeniagde eihret hineepretsvy ro roentesn.ivmo oT my uantergidd,nns hte tebs ttes rfo camrgpnoi gclatoareic evisblara csrosa ousrgp is a hci uqares tse.t
In antsc,rto a t-stte si duse ot creapmo enbetwe teh esnma fo wto ourgps eduae(msr lveabria stmu be iatiaq.ve)ttun
owlF tRea = tiycloVe x Strlscoanes-oCi Aaer
2 c2m^ x 02 cem/sc x 60 eimsn/c x 1 0L1,0/0 3cm^ = .24 n/Lim
0,010 3m^c = 1 L
yaltirlle wkno ereyv gniels name eyht can isopsylb lacl sthi
eTh lav-euP is clabyails etyp 1 ,error nad thye ekep eth -alpveu teh mase at( )&tl.50; ni hobt nsoriesv fo eth enr.mexsetip By srenaicign uebnrm fo ietpstna ni eht uopg,r htey arisenec orpew of eth u,sydt chiwh sdureec teyp II rreo.r
ehT siqonute si ignrerfre ot teh moaxhenise tha.ywap
mabCyalor ehpoaptsh adn nnigeira ear vldnioev ni eth aeru lccey. oS is ltnaaty-gcuamtlee ANG() (aetlsugre niupodortc fo claraybom apeh.pto)sh
jGoanl tesserss eth doaBsr ignivg the eueimlak sunqesiot aywa dbesa no hte age evngi in teh nitouqes t.smse
LLA = 410-
MAL = 1;95-3 -4509
CLL = 60+
CLM = 9450-
jmo0erofdl3iutsphtoutt/mt/nakle/s0.ogeassh/-anr5no:.63n-c.utresetd/d
Tnarne taesgs arstt at TEN seray ldo
Sgeta :I
tSega II 2:)( satge II strats ta 11 o/y (II kolo klie 11)
Segat III :)(3 atssrt ta 13 /yo
Satge VI :4() atrsst at 14 yo/
ateSg V ():5 15 oy/
horSt awsrn:e All genes ear setepnr ni thbo B dan T ,scell tbu heyt gernarear adn pseesrx esorrctpe ttha rea ipiescfc ot trhei geeinl.a rehiT rea eidtdnnpeen VDJ ignorse rof B elcl ecpoetrr oertninaeg adn T lelc ctroeepr egianoenr!t Tihs ikwi ielrtca dshse tihgl on ish:t
iiol:/rbiln/.isi(e)T.aerhkicwiect_#se/pJ_aDtceo/eonnprVkgtp_omtdrw
I oto gralilatyc ssmdie hts.i. ubt ti is clyualat os ilsmpe atth ew aer misigsn the stoerf rhhugot the ertse eih l--W obht B and T eclsl oneudrg DJV rtrneer,mgaena eht ,V ,D adn J nsege ear NIFREFEDT NESEG sietpde negbi oazdnrgei dan eeefrrhto iisedcafls ni a msialri hiosafn edu to rieth hrdase dnee to gateeenr isrdvee rtur.sutsec To kaem seatrtm rmoe ungicofs,n bhto sets of DJV engse are on rcosmoehmo 4.1
siTh is ywh the NBEM icfipsede ahtt tyeh are gtgangi HET MASE J IGENOR hwich is thta of eht B llce rrectoep neeg J no,geri not hte T cell proecert gnee tabe-J oering e(se iwik )eri.alct hTe B cell eprocrte egne si ton neragrraed in a T ce,ll if ti w,as T eclsl uwdlo vhae !tdenabiios
:A etohiyrsrelacmn nad hroet ielb iadc srnesi vetrpen eth eruekpta of ibel scdia morf het tug.
:B aittSns hntibii A-MCHoG tasuerdec, neretnpvgi het vriel orfm mkgina nvicoamle dica, a sruepcror ot .leslorcheto
C: iaNcin cnniicto(i cai)d desrecu ephacti VLDL tshiynses nda asol iihsintb lsilyopis ni pdeiaso tussei yb biigiithnn nomhreo eieitvnss .psliae
Dap;:&Em saetibFr rgaepluetu reltoopinip lpasie L,(L)P ianrenicsg reyitrecglid cacnareel LD(VL dna lcihsomnryoc rae lulf fo dgil)errteiycs dna salo aeivtcat oeeixpmrso rpcifdrleet-atoiaavotr e-terpcor ahlap -haA(P)lapPR ot iudnce LDH yshsseit.n
Godo ctaf to momcti ot rmmy:eo uyo oels bbriac ni eth stool eenhc( yhw deaharri cuseas nnnanioo gap bamleicto od,sa)isci dna laescelipy elos sauotispm tiwh xvlaiate uaseb (as oineendtm in eth eisqntuo ).smte r-ithc-p/om.edttana/wsasl-.-bhc-sduanwctlr:b-areiittiwea/dd/ielcystoaateoeepnnootewrthm
raytHoninvptleie dsarecee OaCP.2 tCrneal ccoerteepshrmo enrposd ot low C2OaP yb canigtioovsrncst clraerbe bodol svseels.
A) iratAler looBd enxgOy tnroenCtaconi: olodB gOneyx nConronttciae si ryteicdl etrlaed to bH nccrtonioeatn adn tauotisanr (2S)Oa ,90F12A p. 365. aiV teh hroB ffcEet, eeecddasr O2aPC lilw acreiesn O2S,a shut iicngesnar odobl ygnoxe cto.riontnanec
)B trialAer loodB 2OP: 2OaP aghecns ni ossneper to edcaeders POA,2 PI2,O or u.ifsdifno eThre ldouw eb no canegh ni Pa2O gnduri vrtilennhipytoae earltohtey(cl).i
)C leraiAt erussPer: eeedraDcs PaO2C si seisoactad wthi svco,riiostntcnao hiwhc uwdol rsieecan odlbo urrssee.p
E) aeerrbCl esiuTs Hp wlduo saerecin deu to ersrtpairyo osislkaa.l
ornchCi eanrl fuecin:fiycnsi
1) rpoo pehoaptsh nacerleac -;tg&- high sumre rngnaicoi posophuhsor
2) hhig eumrs ppetahsho t;g&-- eocmspexl thwi tndvilea octain aC -;t&g- Ca flsla
3) Ca alslf g&-;t- eirggrst PHT xsai
4) ydenik afuirel ;&t--g eedsaderc atiyitcv fo ylsyx-raehd1o ta the kinedy g&;-t- lses lriiotccal
Dman I efel liek MBNE ufgcikn eslov eiasbsc ro meso tsh.i
iThs is eonrtha ouqtsien gtnties eth cencopt of slaptai .yaanotm fI teh euornsg is igtnifl eth lrvie dan ethn the lbeed ntwe fmro a mlsal oanmtu to a dsednu vissmae gahm,horeer lylecar sthi si ipigylmn het ebled si iuocngrc hdebin eht .ilvre
thaW cuttrrseu is nedhbi teh vrel?i ICV
aWth cnocestn ot the ICV rofm the lrvie? epHtica sievn
osAl teh aied ahtt eth pieantt has nebe beelnidg fro 6 husro eacbseu astht how logn ti ootk tnuil the relptoaxroy apromlatya was deoemprfr anesm eth ldebe si tsmo lkylei mfor a olw prseusre s.t.s.eym seounv ye.smst
I gto hist neo iva scrpsoe of naemnoi.iilt Not ersu hwo you era deospsup ot eberemmr lla tath hsit.
Of eshet otpinos aaib,evlal cawnnSh clesl dwulo eb teh lyno sllce nteprse ni hte NPS. sAscoytte,r icrmgaiol nad soiglo aer lla SCN lcesl ilelatS et clles rea ni eth lcuesm nad veser to adi ni seclum repria dan eiganetorern
If you nwat to kinth fo shti ypls,mi teh birs era nencocdet postrloeryi to het atrvbeler l.mocun and het srontaietlc ivsne urn nebewet etm,h so hyet era eht lscsoet to the erabrltve cmn.luo
'mI a imlpes a,nm I ees cpatieliehns nda mpalrtoe oleb nvnivtmelo, I cclki srepe.h
tmeneaBs mbnmreea eitgrtyni si the dnntmeertia fo llfu lung evcyerro nowlliofg yupnamrlo slnu.ti
:Syaurmm
)1( osls fo nmbeaste nbamreme ieytritng si cliatcir ni gnnermdieti teh βtinpo of no βutrner, dan rnttuboisce to hte yitibnlai ot trishaeebls ormlan nlgu hcicrtueeatr whti montroiop fo ;ssirbofi
2)( ossl of laitpeleih c,lesl diehenltola cl,les dan netesbma eraemnmb yentgiitr ni uusla eiarnliisttt iupneoanm oaseacsidt iwth datcopiihi ranymoulp oiissrfb lsaed ot ydseetord gnul acrhurteicte nad etpaelpur i;sbsoirf
()3 omrngsanrfti tgwohr arΞ²tf-co si ,sraynsece tub otn lenriety itu,csefinf ot petomro terenapmn ;sosbifri
4)( rpeentitss jrnarent/ytrtaiiuinig/n is liccrtai rof het pooaranipgt of ;birsfiso
)(5 ipciiatdho alrnmypou srfibosi si na peaxeml of a erpsocs adetrle to eht seipseetcrn fo an nae(,iβntβgs) irnccoh ionnmlaifa,mt nda io;fsirbs dan
()6 uunieq slcel rea tcaiiclr rclulale alepysr in eht aulnitgreo of birsisof.
ntatii: cotwep/16bPlnp/s4/mnrcihMC5.cv/t.4w.2co:.nsal/twg/hi2mi
Nto 001% sreu no hsit one, utb ehseβr owh I odcahpraep it: iistnehma esusac ratiealr nilotadi ece(d=dsrae aerrtraoli tr)i,eenscas ubt all of thta dbloo ash to og mesohewer iscen ouy nwo eavh meor lodob lwignof uhrthog het eaierrts and taht swoehemre si het lpiserlcaia (seireadnc llyairpca htyictdaors ersuspr).e iemnaistH cesusa sndrieace myreiblitpae fo the osarapc-lyptli enulves noe( of Dr. taβstSar toefravi )catfs so oyuβd ahve nsdecreia yllcaprai floniiattr tr.ea
ishT quisento ash a tol of awersn ,oistonp and uyo raervi ta leatihiNrsiphos yb hrniowgt tuo all the ohtre oitnsop yb atwh si ingi.sms
,A B - Crcolait Nsorcesi adn yalpaPlir riocNses tosaml aasywl crocu ni the igetnts fo shai.emic vPeuyolsir lyetahh 82 erya ldo anm has no eidvecen fo iftyniscnialg drasdceee elran fnoepsiur.
C - Autec laruuTb eorissNc is awth ouy ulhods khnti fo tiwh eyStaclial DNAIS() ti.otiyxc Three aer ymna hrteo porthnoiecx rsudg ttha aecsu TNA, utb thnik of ANT sa rudg ndidceu edkiny md.eaga
D - Ciitsyts - knlaF napi is artldee to kiyned ryunj,i nto ddlbear e.dmaga sitCstyi lucod eb lossebpi ni esdigannc TI,U btu het ntaiept sha no veref dna is leam ch(um ssle nomomc in e.)msla
E - pnurGlerooiselmhti - shTi egts into cirtohpecin/trihnpe dsmyenosr. hTe tmse steinnmo htat he sah bolod ni eth nurei whhci mya dela yuo dnwo het iiehncrtp yhatwp,a tbu eh does nto hvea nay of the ohtre edssatiaco tssy.pmom
F - mhyproHenrpea - reAtonh dwro orf lneRa leCl oai.amrcCn No ihtweg lsso ro rhote eccran rdelaet myomtpss ifug(eta e.c)t
G - linteritsaIt piiNrsthe - sTih si otenf a rdug neiudcd EMIMNU demeitda tnyeirpx.ohciot iTsh si a ptye VI vpteyhsiiinesyrt entoraci thta rccuso weeks ot nstomh efrta het tsatr fo oeiactindm iekl( .sNADIS) ATN si mero cssteaoiad wthi urdg dvoeosre eilhw tstrtileaIin is oerm iasceatsdo hitw mminue ie.aornct trantIlieis trephiNis will vhae WBC astcs in nu.ier
I - rnPiyislohptee - daCsue by edingsnac UTI tbu on reefv is ptsn.eer
sihT veales soriaehhspNtlii H)( sa teh rcortec anew.rs 85% of pNishesotrhliia is ditsaoacse iwht pyitoehvac weobl sn.odus eTh pian for alreptonissiihh can sapelre and rti,em dan lcsocyalaoni eht anip cna vatrel mrfo hte deykin l(nfka pa)in ot eth turcoms sa eht otnes evmos tuohrhg het rtuer.e
sA ym ioB 101 sfosrpoer dues ot a,sy the nswera ot rgitevhyne si teeihr xes ro uarfcse ear.a
I drite ot esu lcgoi ot serwan tihs stquoien (I ddi otn nwko autob the oaexmnsehi w.pthy)aa eeHr si my amtht-sipett- si lbapryob owgrn herswmo.ee
I edufrgi htat if you atnw to maek icogmse,luan yuo deen to emoncib csguleo + an inmea rpoug
A() nrigAein I wenk wsa odvlvien ni dinontga eingon,rt tub ti is ni hte aeru clc,ye so I dirfuge this wsa yaorbplb not hte nawesr tbu ti dha tnotpaeli. I ifdeurg ttha eth armoj wya ihst mpoucndo rsoemve tis egiontnr si gruothh eur,a ghhotu.
(B) PT.A niceS PF6 adarley sha the hsehpatop gr,oup I rduefgi APT is ybaoplbr tno syraeensc sa hte noucdmpo ni etoqisun deralay has a O4P oprug.
()C moaCyrbal teoa.psphh I wnek hsit swa lieonvvd in othb teh raue ccely and uneslciode hnssey,sit os sthi swa elss illy.ke It aols is the crtopud fo a 3HN adn OC2 os htat smnae htat I no'lwutd cxptee it to toedna na maine rpguo
)D( Gnietlmau I rudefgi has an nemai ruogp thcedtaa ot it edyar fro ondinot.a I salo kwon ahtt mntsornaitnaai ntaeiorcs ear mconom itwh naomi cidas dna hdasta-ekpiocla .g.(e lhpaa ktrleteuoagta whit alaenni nca egt ouy legtmtaau dan a tuevayrp iav ALT) hstu it dmae seens htat na naomi acdi coldu nadtoe na nimea gup.or
)(E The yonl ghint I wken bauto ANG saw htta ti swa sude in eth earu lcecy as an rlltcsioea voitracat fo ,SCP so I nitd'd tkinh hatt ti swa uesful sa a aotdron of genirotn inesc ist ionutcnf is ot ehlp adi rtnignoe econxrit.e
So ehnt I was utkcs tneewbe A adn ,D tbu baeds no rnsiatitnnaaom sea,cotirn I cpiedk .D
A 66-year-old man develops worsening ...
Dilution of serum sodium due to ADH (vasopressin) secretionπ,πΊ