Metabolic response to injury
General Surgery · Topic 1
Source: NMC CBME Curriculum 2024 · Volume III · General Surgery · Topic 1 · combined PDF page 403
Practice questions
- Which combination best characterizes the flow phase of the metabolic response to injury?
- A patient with serious tissue injury is eating poorly but has increased energy expenditure and protein catabolism. Which comparison with uncomplicated starvation is most accurate?
- Which pair of mechanisms is described as initiating neuroendocrine and metabolic responses to tissue injury?
- Which statement best explains the apparent nutritional paradox after major injury?
- A patient with continuing serious tissue injury receives nutritional support, but catabolism persists. Which interpretation is best supported?
- Which change in skeletal muscle is most directly associated with increased loss of body protein in trauma and sepsis?
- In a patient with trauma, muscle protein synthesis is found to be increased. Which conclusion about net muscle protein balance is most appropriate?
- Which pattern is consistent with the protein-metabolic response to uncomplicated starvation described in the literature?
- A severely injured patient has reduced intramuscular glutamine concentration. Which mechanism is identified as a possible explanation?
- Which hepatic protein-synthesis pattern is most consistent with trauma or sepsis?
- Which group consists entirely of selected proteins whose hepatic synthesis may decrease during trauma or sepsis?
- Which tissues are identified as having early alterations in protein-synthesis capacity during trauma or sepsis?
- In the injury response, what is reported about glutamine use in rapidly replicating tissues?
- Which set of potential mediators is identified in relation to altered protein metabolism after trauma and sepsis?
- A patient with a severe burn continues to show profound catabolism months after injury. Which statement is supported by the burn literature cited here?
- For a severely burned patient, which environmental temperature range is identified in the supplied review as an anabolic care strategy?
- Which early wound-management strategy is specifically listed as an anabolic approach in severe burn care?
- A patient with a severe burn develops sepsis. Which action is included among the described strategies to limit persistent catabolism?
- Which nutritional regimen is identified in the supplied severe-burn review as part of an anabolic strategy?
- Which exercise approach is included among strategies to limit lean-body-mass erosion after severe burn?
- Which group contains only pharmacologic approaches discussed as ways to minimize lean-body-mass erosion after severe burn?
- Which statement best reflects the relationship between insulin and amino-acid flux in skeletal muscle in the flow phase?
- A postoperative patient is kept in a warmer environment, and urinary nitrogen excretion decreases. Which interpretation is consistent with the supplied review?
- Why may the metabolic response to injury be adaptive initially but harmful when serious illness is prolonged?
- Which statement about energy expenditure in uncomplicated starvation versus serious disease is most accurate?
- A critically ill patient is losing functional protein mass during a prolonged course of serious disease. Which metabolic process best explains this observation?
- Which intervention set most closely matches the nonpharmacologic severe-burn strategies described in the supplied review?
- Which statement about anabolic pharmacologic treatment after severe injury is best supported by the supplied reviews?
- A patient with serious injury has anorexia, increased energy expenditure, and ongoing protein breakdown. Which explanation best accounts for why this is not simply the usual response to reduced food intake?
- Which statement about the relative importance of proposed mediators of altered protein metabolism is most accurate?
- Which clinical observation most strongly indicates that the response to serious injury differs from the normal protein-conserving response to starvation?