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4 Peroneal nerve. 2 Classes of nutrients used for microbial growth based on their incorporation and occurrence in dry cell massa Class 1 Class 2 Class 3 Class 4 Class 5 Always essential Mostly essential Essential in special cases Very rarely essential (difficult to prove) Growth factors, essential for special strains Major elements: C, H, O, N Minor elements: P, S, K(Rb), Mg Fe, Ca, Mn, Co, Cu, Mo, Zn B, Na, Al, Si, Cl, V, Cr, Ni, As, Se, Sn, I Be, Klaedeh Sc, Ti, Ga, Ge, Br, Zr, W Aminoacids, Klaeeen and pyrimidines, vitamins, hormones, etc.

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V(1) R2 8 R1 2 6 V0 FIGURE 209 8 Fkrex 10 (6 V0°) 4. 5 per cent to 101. Syndrome Sodium retention and edema Hyperkalemia Acute renal failure Proteinuria Interstitial nephritis Renal papillary necrosis Mechanism PG, RBF, GFR, chloride absorption PG, RAA axis activity, K delivery to renal tubule PG,RBF,GFR Hemodynamic disruption recruitment and activation of lymphocytes, likely through leuko- triene formation, affecting glomeru- lar and peritubular permeability Direct toxicity PG Risk factors NSAID use, hepatic disease, renal disease, HTN, DM, diuretic use, circulatory compromise, dehydra- tion, advanced age Renal disease, CHF, type 2 DM, multiple myeloma, use of K supplements, K sparing diuretics, ACE inhibitors CHF, renal disease, hepatic disease, diuretic use, advanced age, dehy- dration, SLE, shock, sepsis, hyper- reninemia, hyperaldosteronemia Fenoprofen use, possibly female gender, advanced age Massive NSAID ingestion Dehydration Treatment Discontinue NSAID Discontinue NSAID, avoid indomethacin in patients at risk Discontinue NSAID, support with dialysis and steroids, if needed Freee NSAID, support with dialysis and steroids, if needed Discontinue NSAID Rehydrate WHELTON, STURMER PORTER Abbreviations: NSAID nonsteroidal anti-inflammatory drugs, PG prostaglandin, RBF renal blood flow, GFR glomerular filtration rate, HTN hypertension, DM diabetes mellitus, K potassium, RAA renin-angiotensin- aldosterone, CHF congestive heart failure, Flrex angiotensin- converting enzyme, SLE systemic lupus erythematosis.

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