April Jernigan is a 64-year-old teacher with a 10-year history of chronic lung disease.  Despite advice from her doctor to quit smoking, Ms. Jernigan continues to smoke two packs of cigarettes a day.  She is admitted to the hospital with dyspnea, fatigue, and significant pedal edema.  She has a significant “smoker’s cough” and a specimen of sputum has been sent to the laboratory for analysis. Vital signs are 39.8C, 118, 26, 168/104. The following laboratory values are obtained:   Ms. Jernigan’s CBC reveals that she has likely developed which of the following?  

Jon Gibbs is a 28-year-old college student who has been reportedly healthy with the exception of recent fatigue and low energy.  School “has been stressful this year” but he says that he tries to exercise and eat as well as he can to stay healthy.   Mr. Gibbs faints in class and falls, hitting his head on a desk on the way to the floor.  911 is called and emergency personnel arrive!  Vital signs are 37.9 C, 112, 30, 200/104.  The cardiac monitor displays an irregular cardiac rhythm with premature ventricular contractions (PVCs).  A swollen, red area is noted on the back of his head from the fall.   Mr. Gibbs is subsequently admitted to the hospital.  You observe that he is alert, shaky with trembling hands, anxious, and weak.  Skin is dry and mucous membranes are moist.  He has bilateral edema of his feet and ankles.  A chest x-ray reveals myocardial hypertrophy, and a computerized tomography (CT) scan of the head is negative. Serum Electrolytes are assessed. Na 152 mEq/L                           Cl 104 mEq/L                          K 6.4 mEq/L BUN 42 mg/dl Creat. 3.4 mg/dl CO2 23 mmol/L Ca 7.2 mg/dl Mag 3.7 mEq/L Phos 5.6 mg/dl Glucose 132 mg/dl Albumin    4.4 g/dl   Lactic Acid 1.8 mEq/L   The most likely cause of Mr. Gibbs’ hypoxia is which of the following?

Mr. Collins is a 59-year-old male with a history of vomiting blood.  He has been in good health except for hypertension and “stomach problems”, including chronic indigestion and heartburn usually relieved with over-the-counter antacids.  He reports a poor appetite and recent weight loss.  Mr. Collins states that he has a very stressful job at times, and he jokes “I knew this job would give me an ulcer”.  Mr. Collins reports that last evening the heartburn was particularly bad, but he experienced relief after taking his antacids.  He awakened early today with nausea, bloody emesis, weakness, and dizziness.  He also reports black tarry stools. His wife drove him to the emergency room where he was admitted with an upper gastro-intestinal bleed. He is alert and oriented X3, breathing is quiet and unlabored.  Skin and mucous membranes are pale and dry.  There is 90 mL of dark, concentrated urine in a bedside urinal.  An endoscopy reveals esophageal metaplasia and numerous gastric and duodenal ulcers.  A chest x-ray shows normal lung fields with myocardial hypertrophy.  An electrocardiogram (ECG) shows sinus tachycardia with occasional Premature Ventricular Contractions (PVCs). Vital signs are:  36.9 C, 112, 30, 94/42, and 98% Oxygen saturation. The following laboratory values were assessed: Serum Electrolytes Na 130 mEq/L    Cl 89 mEq/L   K 6.2 mEq/L BUN 52 mg/dl   Creatinine 2.4 mg/dl   CO2 16 mmol/L Ca 7.6 mg/dL   Mag 1.5 mEq/L   Phosphorous 4.4 mg/dL Glucose 138 mg/dL   Albumin 3.0 g/dL   Lactic Acid 1.8 mEq/L   Considering Mr. Collins’ autonomic nervous system status, you expect him to develop which of the following?

Ms. Ewing typically sits in a wheelchair most of the day, however lately she has felt too weak and has been staying in bed most of the time.  Skin breakdown has developed on her coccyx and elbows with notable erythema, edema, warmth, tenderness, and yellow drainage.  Ms. Ewing has not been able to rate her coccygeal pain using a pain scale, however she moans, cries, and pushes you away when her coccyx is touched.  Otherwise, Ms. Ewing has intact, dry skin and mucous membranes, pitting edema of both legs and feet, and scant urine output.  Vital signs are:  38.7, 112, 26, 96/44.  The following laboratory values were assessed: Serum Electrolytes Na 155 mEq/L Cl  106 mEq/L K 2.9 mEq/L BUN     18 mg/dl Creat. 1.1 mg/dl  CO2 19 mmol/L Ca        7.9 mg/dl Mag     1.7 mEq/L Phos   4.7 mg/dl Glucose        185 mg/dl                Albumin   2.9 g/dl                          Lactic Acid   6.0 mEq/L   Ms. Ewing’s blood pressure would cause stimulation of which of the following?

Mr. Collins is a 59-year-old male with a history of vomiting blood.  He has been in good health except for hypertension and “stomach problems”, including chronic indigestion and heartburn usually relieved with over-the-counter antacids.  He reports a poor appetite and recent weight loss.  Mr. Collins states that he has a very stressful job at times, and he jokes “I knew this job would give me an ulcer”.  Mr. Collins reports that last evening the heartburn was particularly bad, but he experienced relief after taking his antacids.  He awakened early today with nausea, bloody emesis, weakness, and dizziness.  He also reports black tarry stools. His wife drove him to the emergency room where he was admitted with an upper gastro-intestinal bleed. He is alert and oriented X3, breathing is quiet and unlabored.  Skin and mucous membranes are pale and dry.  There is 90 mL of dark, concentrated urine in a bedside urinal.  An endoscopy reveals esophageal metaplasia and numerous gastric and duodenal ulcers.  A chest x-ray shows normal lung fields with myocardial hypertrophy.  An electrocardiogram (ECG) shows sinus tachycardia with occasional Premature Ventricular Contractions (PVCs). Vital signs are:  36.9 C, 112, 30, 94/42, and 98% Oxygen saturation. The following laboratory values were assessed: Serum Electrolytes Na 130 mEq/L    Cl 89 mEq/L   K 6.2 mEq/L BUN 52 mg/dl   Creatinine 2.4 mg/dl   CO2 16 mmol/L Ca 7.6 mg/dL   Mag 1.5 mEq/L   Phosphorous 4.4 mg/dL Glucose 138 mg/dL   Albumin 3.0 g/dL   Lactic Acid 1.8 mEq/L   Mr. Collins’ heartburn and gastric and duodenal ulcers may have been caused by increased gastric acid secretion secondary to secretion of which of the following?

Mr. Collins is a 59-year-old male with a history of vomiting blood.  He has been in good health except for hypertension and “stomach problems”, including chronic indigestion and heartburn usually relieved with over-the-counter antacids.  He reports a poor appetite and recent weight loss.  Mr. Collins states that he has a very stressful job at times, and he jokes “I knew this job would give me an ulcer”.  Mr. Collins reports that last evening the heartburn was particularly bad, but he experienced relief after taking his antacids.  He awakened early today with nausea, bloody emesis, weakness, and dizziness.  He also reports black tarry stools. His wife drove him to the emergency room where he was admitted with an upper gastro-intestinal bleed. He is alert and oriented X3, breathing is quiet and unlabored.  Skin and mucous membranes are pale and dry.  There is 90 mL of dark, concentrated urine in a bedside urinal.  An endoscopy reveals esophageal metaplasia and numerous gastric and duodenal ulcers.  A chest x-ray shows normal lung fields with myocardial hypertrophy.  An electrocardiogram (ECG) shows sinus tachycardia with occasional Premature Ventricular Contractions (PVCs). Vital signs are:  36.9 C, 112, 30, 94/42, and 98% Oxygen saturation. The following laboratory values were assessed: Serum Electrolytes Na 130 mEq/L    Cl 89 mEq/L   K 6.2 mEq/L BUN 52 mg/dl   Creatinine 2.4 mg/dl   CO2 16 mmol/L Ca 7.6 mg/dL   Mag 1.5 mEq/L   Phosphorous 4.4 mg/dL Glucose 138 mg/dL   Albumin 3.0 g/dL   Lactic Acid 1.8 mEq/L   Mr. Collins’ calcium levels may have been caused by which of the following:

Jon Gibbs is a 28-year-old college student who has been reportedly healthy with the exception of recent fatigue and low energy.  School “has been stressful this year” but he says that he tries to exercise and eat as well as he can to stay healthy.   Mr. Gibbs faints in class and falls, hitting his head on a desk on the way to the floor.  911 is called and emergency personnel arrive!  Vital signs are 37.9 C, 112, 30, 200/104.  The cardiac monitor displays an irregular cardiac rhythm with premature ventricular contractions (PVCs).  A swollen, red area is noted on the back of his head from the fall.   Mr. Gibbs is subsequently admitted to the hospital.  You observe that he is alert, shaky with trembling hands, anxious, and weak.  Skin is dry and mucous membranes are moist.  He has bilateral edema of his feet and ankles.  A chest x-ray reveals myocardial hypertrophy, and a computerized tomography (CT) scan of the head is negative. Serum Electrolytes are assessed. Na 152 mEq/L                           Cl 104 mEq/L                          K 6.4 mEq/L BUN 42 mg/dl Creat. 3.4 mg/dl CO2 23 mmol/L Ca 7.2 mg/dl Mag 3.7 mEq/L Phos 5.6 mg/dl Glucose 132 mg/dl Albumin    4.4 g/dl   Lactic Acid 1.8 mEq/L   Mr. Gibbs’ edema of his feet is most likely caused by which of the following?

AE_2220_Exam1_Spring_2025-2.pdf

Consider the scenario shown below, with four different servers connected to four different clients over four three-hop paths. The four pairs share a common middle hop with a transmission capacity of R = 200 Mbps. The four links from the servers to the shared link have a transmission capacity of RS = 10 Mbps. Each of the four links from the shared middle link to a client has a transmission capacity of RC = 30 Mbps.   ‘ What is the maximum achievable end-end throughput (in Mbps) for each of four client-to-server pairs, assuming that the middle link is fairly shared (divides its transmission rate equally)?

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