Author: Anonymous

B. Read the following passage, and answer the questions (Q1-Q5).  오늘 수빈이는 친구 민지와 같이 옷을 사러 백화점에 갔습니다. 백화점 안은 쇼핑하러 온 사람들 때문에 아주 복잡했습니다. 수빈이는 요즘 유행하는 짧은 치마와 블라우스, 그리고 굽이 높은 샌들을 사고 민지는 운동할 때 (B) _____ 편한 바지와 티셔츠를 샀습니다. (C) 한국은 유행이 자주 바뀌어서 옷 사기가 어렵습니다. 민지는 캐나다에 계시는 아버지께 (D) _________ 얇은 편 자켓도 하나 샀습니다. 세일을 해서 반값으로 싸게 살 수 있었습니다. 그런데 현금이 모자라서 카드로 냈습니다. 수빈이하고 민지는 마음에 꼭 드는 옷을 싸게 사서 기분이 아주 좋았습니다.   백화점이 왜 복잡했어요? (4pts)

C. Listen to the conversation, and answer the following questions (Q1-Q5). 1) 소피아는 방학 때 어디 갔다 왔어요?  __________ (3pts)

B. Listen to the conversation, and answer the following questions (Q1-Q5).  1) What does 천천히 골라 보세요 mean? __________ (3pts)

A. Listen to the conversation, and answer the following questions (Q1-Q5). 5) 야구장에 갈 때 왜 두꺼운 옷을 입고 가야 돼요? __________ (4pts)

A. Listen to the conversation, and answer the following questions (Q1-Q5). 4) “이번 주엔 날씨가 따뜻했으면 좋겠어요.” 은 무슨 뜻(mean)이에요? __________ (4pts)

C. Listen to the conversation, and answer the following questions (Q1-Q5). 2) 소피아의 한국 여행은 어땠어요? __________ (4pts)

Please log into the following website and complete the assessment titled “ATI RN Pharmacology Online Practice 2023 A” www.atitesting.com I have completed the ATI RN Pharmacology Practice 2023 A by accessing this “quiz” through HonorLock.  RN Pharmacology Online Practice 2023 A – is open & available for completion.  ***Handwritten remediation & Individual Performance Profile submission due by Monday November 24th at 11:59pm. (See ATI Module for submission details.)

Please log into the following website and complete the assessment titled “ATI RN Pharmacology Online Practice 2023 B” www.atitesting.com I have completed the ATI RN Pharmacology Practice 2023 B by accessing this “quiz” through HonorLock.  RN Pharmacology Online Practice 2023 B – is open & available for completion.  ***Handwritten remediation & Individual Performance Profile submission due by Monday November 24th at 11:59pm. (See ATI Module for submission details.)

Describe the relationship between preload, afterload, and contractility. Include discussion of the Frank-Starling law as it relates to these relationships.

Cirrhosis 1. Background Definition: End-stage fibrosis and nodular regeneration of the liver resulting from chronic liver injury, leading to distortion of hepatic architecture, portal hypertension, and hepatic insufficiency. Pathophysiology: Chronic hepatocellular injury (inflammation, necrosis) → fibrosis → nodular regeneration → disruption of hepatic blood flow and function. Portal hypertension develops from increased intrahepatic resistance. Etiologies: Chronic viral hepatitis: HBV, HCV (most common worldwide). Alcohol-associated liver disease. Nonalcoholic steatohepatitis (NASH). Autoimmune hepatitis, hemochromatosis, Wilson disease, α1-antitrypsin deficiency, biliary disease. Epidemiology: A leading cause of death worldwide. Increasing prevalence due to metabolic syndrome and NAFLD/NASH. 2. History Early (compensated): Often asymptomatic or mild nonspecific fatigue, weakness, or anorexia. Decompensated (advanced): Jaundice Ascites Peripheral edema Hepatic encephalopathy (confusion, asterixis) Gastrointestinal bleeding from esophageal or gastric varices Easy bruising or prolonged bleeding (coagulopathy) Other features: Pruritus (especially in cholestatic causes) Dark urine / pale stools Sexual dysfunction, gynecomastia, menstrual irregularities (endocrine effects). 3. Exam Findings General: Jaundice, muscle wasting, fatigue. Skin: Spider angiomas, palmar erythema, bruising, jaundice. Abdomen: Hepatomegaly (early) → small, shrunken liver (late). Ascites, shifting dullness. Splenomegaly (portal hypertension). Caput medusae (distended abdominal veins). Neurologic: Asterixis, confusion (hepatic encephalopathy). Endocrine: Gynecomastia, testicular atrophy. 4. Making the Diagnosis A. Laboratory Findings LFT pattern: AST > ALT (esp. alcoholic), elevated bilirubin, low albumin, prolonged PT/INR. Other labs: Thrombocytopenia (splenic sequestration), hyponatremia. Confirmatory: Elevated serum fibrosis markers or biopsy (definitive but not always required). B. Imaging Ultrasound: First-line; shows nodular liver, splenomegaly, ascites. Elastography: Noninvasive measurement of liver stiffness. CT/MRI: Evaluate for nodularity, portal hypertension, HCC. C. Assessing Severity Child-Pugh score: Grades liver function (bilirubin, albumin, INR, ascites, encephalopathy). MELD score: Predicts mortality and determines liver transplant priority. D. Complications to Screen For Hepatocellular carcinoma (HCC): Ultrasound ± AFP every 6 months. Varices: Screening endoscopy. Hepatorenal syndrome spontaneous bacterial peritonitis (SBP) (ascites with >250 PMNs/µL, fever, abdominal pain) 5. Management A. General Management Treat underlying cause: Abstain from alcohol. Antivirals for HBV/HCV. Weight loss for NASH. Chelation (Wilson disease) or phlebotomy (hemochromatosis). Avoid hepatotoxins (NSAIDs, acetaminophen >2g/day). Vaccinations: HAV, HBV, influenza, pneumococcal. B. Management of Complications Complication Management Ascites Sodium restriction, diuretics (spironolactone ± furosemide), paracentesis, avoid NSAIDs Spontaneous Bacterial Peritonitis (SBP) Empiric cefotaxime; prophylaxis with norfloxacin or TMP-SMX Variceal Bleeding Octreotide, endoscopic band ligation, nonselective beta-blockers (propranolol/nadolol) for prevention Hepatic Encephalopathy Lactulose ± rifaximin, avoid sedatives Hepatorenal Syndrome Albumin, vasoconstrictors (midodrine/octreotide), treat precipitating factors C. Definitive Therapy Liver transplantation: Only curative option for end-stage disease. Indicated by MELD score ≥15 or recurrent decompensation.   Question A 58-year-old man with a history of alcohol-associated cirrhosis presents with increasing abdominal distension and confusion over the past week. His temperature is 100.6°F (38.1°C), blood pressure 102/64 mm Hg, and pulse 96/min. On examination, he has jaundice, ascites with shifting dullness, and mild asterixis. Paracentesis reveals: WBC count: 420 cells/µL (80% neutrophils) Protein: 0.8 g/dL Culture: Escherichia coli Which of the following is the most likely complication responsible for this presentation?