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sorry ..500 - 200=300
wht about the 3rd one? tyramin effect on eye? it is question #57 (is in the link):
The circles represent the size of a patient's pupils without treatment and following treatment with tyramine and with
epinephrine. Which of the following is compatible with the findings shown for the left eye?
(A) Blockade of α-adrenergic receptors
(B) Blockade of β-adrenergic receptors
© Blockade of muscarinic receptors
(D) Inhibition of cholinesterase
(E) Sympathetic denervation
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57. The correct answer is E. There are two muscles that separately control the diameter of the pupil. The radial dilator muscle, which contracts (producing mydriasis) with α-adrenergic receptor stimulation, is under the control of the sympathetic nervous system. The pupillary sphincter muscle (sometimes called the pupillary constrictor muscle) produces pupillary constriction with muscarinic cholinergic receptor stimulation and is controlled by the parasympathetic nervous system. Without treatment, the left eye is slightly smaller than the right, which by itself could indicate either decreased sympathetic tone or increased parasympathetic tone in the left eye.
Tyramine is an indirect-acting sympathomimetic (it is taken up by sympathetic nerve terminals and displaces the norepinephrine [NE] into the synapse). For tyramine to work, sympathetic nerves must be intact. Tyramine had an effect on the right eye but failed to affect the left, which is consistent with sympathetic denervation (choice E). However, choice A cannot be ruled out yet because α-adrenergic receptor blockade could have prevented NE™s actions on the radial dilator muscle. The treatment with EPI can distinguish between choices A and E. If the answer was A, then EPI should have no effect. However, EPI produced an unusually large effect in the left eye, which is consistent with sympathetic denervation supersensitivity.
Blockade of β-adrenergic receptors (choice B) can be quickly eliminated because β-receptors do not play a role in controlling the diameter of the eye.
Blockade of muscarinic receptors (choice C) can be quickly eliminated because without treatment, the left eye would be dilated.
If the left eye had been previously treated with cholinesterase inhibitors (choice D), tyramine still could have produced some dilation
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Total gain 200mml/d * 4d =800
loss 30+90+180+200=500
Net gain 800-500 =300
150mmol = 1L 0.9%NaCl = 1Kg
300-------------------------=2Kg
Pt weight 70+2=72Kg
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Thanks a lot, appreciate ur help. GL and plz pray for me! am taking the test shortly!
