Systemic Response to Injury and Metabolic Support

Question 1

Interleukin that is a potent inducer of Acute phase patterns

Answer 1

IL 6

Question 2

C-reactive protein

Answer 2

• Does not increase in reponse to stress in patients with liver failure
• do notshow diurnal variations
• not affected by feeding
• more sensitive than ESR

Question 3

Inflammatory response response following traumatic injury

Answer 3

• The degree of inflammation is proportional toinjury severity
• independent predictor of subsequent organ dysfunction adn resultant mortality
• sterile

Question 4

High-mobility group protein B1 (HMGB1)

Answer 4

• Best characterized DAMP, detectable in circulation within 30 minutes of trauma
• protein secretedby immune competent cells stimulated by PAMPs or inflammatory cytokines
• Also secreted by endothelial cells, platelets, and also as a part of cell death

Question 5

Most Abundant amino acid in the human body

Answer 5

Glutamine (2/3 of the free intracellularamino acid pool)

Question 6

Role of mitochondrialDAMPs in the injury mediated inflammatory response

Answer 6

Mitochondrial DNA and peptides from damaged mitochondria activate the macrophage inflammasome

Question 7

major glucocorticoid in humans and is essential for survival during significant physiologic stress

Answer 7

Cortisol

Question 8

Acts on the anterior pituitary to stimulate the secretion of ACTH into the systemic circulation

Answer 8

ACTH

Question 9

Represents a Clinical syndrome highlighted largely by inadequate amounts of circulating cortisol and aldosterone

Answer 9

Adrenal Insufficiency

• described in patients with atrophic adrenal glands caused by steroid administration
• tachycardia, hypotension, weakness, nausea, vomiting, and fever

Question 10

Nutritional formulas used to treat pulmonary failure typically increase the fat intake of apatient’s total caloric intake to

Answer 10

50%

• goal is to reduce carbon dioxide production
• with a corresponding reduction in carbohydrate content