Editing Anatomy and Physiology – RN Flashcards (section)

== Hematologic and Gastrointestinal ==

;Why can a severely neutropenic patient have a serious infection with no redness or purulent drainage?
:The classic local signs of inflammation are produced by neutrophil migration into tissue. Without neutrophils, the patient cannot generate them, so even a modest temperature elevation may be the only sign of sepsis and constitutes an emergency.

;Which clotting factors require vitamin K, and why does liver disease prolong the international normalized ratio?
:Factors II, VII, IX, and X are vitamin K dependent and are synthesized in the liver. Hepatic failure impairs synthesis, and biliary obstruction impairs absorption of fat-soluble vitamin K, so both prolong prothrombin time and the international normalized ratio.

;Why do prolonged vomiting and prolonged diarrhea produce opposite acid-base disturbances?
:Vomiting and nasogastric suction remove hydrochloric acid from the stomach, causing metabolic alkalosis, typically with hypokalemia and hypochloremia. Diarrhea removes bicarbonate-rich intestinal secretions, causing metabolic acidosis.

;Why does gastric bypass or gastrectomy cause vitamin B12 deficiency?
:Intrinsic factor is secreted by the gastric parietal cells and is required for vitamin B12 absorption in the terminal ileum. Without it, B12 cannot be absorbed regardless of oral intake, producing megaloblastic anemia and neurologic deficits, so parenteral or high-dose replacement is needed.

[[Category:Anatomy and Physiology]]
[[Category:Registered Nurse (NCLEX-RN)]]
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