Glucocorticoids (steroids) are used for their anti-inflammatory action, which decreases the development of edema. Corticosteroids produce their effect through multiple pathways. In general, they produce anti-inflammatory and immunosuppressive effects, protein and carbohydrate metabolic effects, water and electrolyte effects, central nervous system effects, and blood cell effects.

Option A: Diuretics help rid the body of salt (sodium) and water. Most of them help the kidneys release more sodium into the urine. The sodium takes with it water from the blood, decreasing the amount of fluid flowing in the veins and arteries, thereby reducing blood pressure. Diuretics are a medication used in the management and treatment of edematous and other non-edematous disease conditions. Diuretics are a class of drugs.
Option B: Antihypertensive drugs comprise several classes of compound with the therapeutic intention of preventing, controlling, or treating hypertension. The classes of antihypertensive drugs differ both structurally and functionally. They are important in anaesthetic practice because they are commonly prescribed to the general population, with the overall prevalence of hypertension being 31% in the UK [defined by the National Institute for Health and Care Excellence (NICE) as a measurement of 140/90 mm Hg or higher in clinic, with subsequent ambulatory or home measurement of 135/85 mm Hg or higher].
Option D: Anticonvulsants suppress the excessive rapid firing of neurons during seizures. Anticonvulsants, or antiepileptics, are an ever-growing class of medications that act through multiple different mechanisms to control seizures — antiepileptic toxicity commonly presents with a triad of symptoms, which includes central nervous system (CNS) depression, ataxia, and nystagmus.

The blood must be stopped at once, and then normal saline should be infused to keep the line patent and maintain blood volume. Treatment is to stop the transfusion, leave the IV in place, intravenous fluids with normal saline, keeping urine output greater than 100 mL/hour, diuretics may also be needed and cardiorespiratory support as appropriate. A hemolytic workup should also be performed which includes sending the donor blood and tubing as well as post-transfusion labs (see below for list) from the recipient to the blood bank.

Option B: Assessing the pain further could delay any interventions that are needed to be done. Fatal hemolysis is extremely rare, occurring only in 1 out of nearly 2 million transfusions. It is the result of ABO incompatibility, and the recipient’s antibodies recognize and induce hemolysis in donor’s transfused cells. Patients will develop an acute onset of fevers and chills, low back pain, flushing, dyspnea as well as becoming tachycardic and going into shock.
Option C: The blood bank can be notified after stopping the infusion first. According to the American Association of Blood Banks (AABB), febrile reactions are the most common, followed by transfusion-associated circulatory overload, allergic reaction, TRALI, hepatitis C viral infection, hepatitis B viral infection, human immunodeficiency virus (HIV) infection, and fatal hemolysis which is extremely rare, only occurring almost 1 in 2 million transfused units of RBC.
Option D: Vital signs could be obtained after stopping the infusion and infusing normal saline. There are multiple complications of blood transfusions, including infections, hemolytic reactions, allergic reactions, transfusion-related lung injury (TRALI), transfusion-associated circulatory overload, and electrolyte imbalance.

These tests confirm the presence of HIV antibodies that occur in response to the presence of the human immunodeficiency virus (HIV). When there is a possibility of acute or early HIV infection, the most sensitive screening immunoassay available (ideally, a combination antigen/antibody immunoassay) in addition to an HIV virologic (viral load) test is performed. RT-PCR based viral load test is favored. A positive HIV virologic test generally indicates HIV infection.

Option A: History of high-risk sexual behavior is one of the risk factors that predisposes a patient to HIV. In the United States, a critical risk factor for HIV propagation among young people is the use of drugs before having sex, including marijuana, alkyl nitrites (“poppers”), cocaine, and ecstasy. Other risk factors associated with acquiring HIV infection include men who have sex with men, unsafe sexual practices, the use of intravenous drugs, vertical transmission, and blood transfusions or blood products.
Option C: An associated opportunistic infection is one of the complications of HIV. In individuals with chronic HIV infection not on treatment with antiretroviral agents, as the CD4+ count drops they are vulnerable to a multitude of infections which rarely occur in an immunocompetent host, hence the term opportunistic infections (OIs).
Option D: These are symptoms of HIV, but these do not determine a positive diagnosis. A large number of patients may only have an asymptomatic infection after the exposure. The usual time from exposure to onset of symptoms is 2 to 4 weeks, although, in some cases, it can be as long as 10 months. A constellation of symptoms, known as an acute retroviral syndrome, may appear acutely. Although none of these symptoms are specific to HIV, their presence of increased severity and duration is an indication of poor prognosis.

One cup of cottage cheese contains approximately 225 calories, 27 g of protein, 9 g of fat, 30 mg cholesterol, and 6 g of carbohydrate. Proteins of high biological value (HBV) contain optimal levels of amino acids essential for life. In general, proteins from animal sources have a higher biological value than proteins from plant sources. Animal sources of protein are meat, poultry, fish, eggs, milk, cheese and yogurt, and they provide high biological value proteins.

Option A: Raw carrots are rich in beta-carotene and sodium. Plants, legumes, grains, nuts, seeds and vegetables provide low biological value proteins.
Option B: Apple juice is rich in carbohydrates and fiber. Omnivorous diets (containing foods derived from animals and plants) in the developed world provide adequate amounts of protein. However, subgroups of the population who avoid all foods of animal origin may have difficulties in meeting their protein requirements.
Option C: Whole wheat bread contains high amounts of fiber and carbohydrates. However, as the limiting amino acid tends to be different in different vegetable proteins, combination of vegetable sources of proteins in the same meal (e.g. legumes or pulses with cereals), can result in a mix of higher biological value. These combinations are generally found in traditional culinary recipes from the different continents (e.g. beans with rice/pasta/manioc, chick-peas with bread, lentils with potatoes, etc).

Elevation of uremic waste products causes irritation of the nerves, resulting in flapping hand tremors. The classic description has been in hepatic diseases but other causes can commonly cause asterixis including azotemia and respiratory disease. Asterixis is a disorder of motor control characterized by an inability to actively maintain a position and consequent irregular myoclonic lapses of posture affecting various parts of the body independently.

Option B: Hematocrit levels in uremic syndrome are usually very low, which leads to a higher risk of starting dialysis. Anemia-induced fatigue is thought to be one of the major contributors to the uremic syndrome. Erythropoietin (EPO), a hormone necessary for red blood cell production in bone marrow, is produced by peritubular cells in the kidney in response to hypoxia.
Option C: Life-threatening complications, such as hypertension, occur in clients with uremic syndrome. Cardiac arrest may occur from severe underlying electrolyte abnormalities, such as hyperkalemia, metabolic acidosis, or hypocalcemia. Renal dysfunction may contribute to associated fluid retention, which may lead to uncontrolled hypertension and congestive heart failure.
Option D: Several underlying electrolyte abnormalities such as hyperkalemia and hypocalcemia leads to cardiac arrest. Hyperkalemia (potassium >6.5 mEq/L) may be an acute or chronic manifestation of renal failure, but regardless of the etiology, a potassium level of greater than 6.5 mEq/L is a clinical emergency. As renal function declines, the nephron is unable to excrete a normal potassium load, which can lead to hyperkalemia if dietary intake remains constant.