Chapter 26, Problem 9CT

Marvin was driving too fast on a remote mountain road at 3 a.m. when his car left the road and rolled down a steep hill. Marvin sustained numerous cuts and bruises. When medical help arrived 2 hours later, his systolic blood pressure was 70 mm Hg. and his pulse was weak (thready). Intravenous saline was administered immediately, and plasma and then whole blood were administered in the emergency room. After another hour, Marvin's blood pressure had returned to normal and he no longer appeared pale. While he was in the hospital, Marvin's urine volume decreased to less than 30 mL/h (< 400 mL/day). A blood sampleindicated elevated levels of urea, creatinine. and uric acid. He also exhibited hyperkalemia and some cardiac arrhythmia, and hisarterial pH was < 7.35 (below normal). Over the next few days, his red blood cell count decreased and he bruised easily. His jugular veins were distended, and there was some peripheral and pulmonary edema. Form the following list, select the conditions that applied to Marvin at this time.
(1) hypoxic injury to the kidney
(2) increased reabsorption of wastes
(3) decreased ${\text{H}}^{\text{+}}$ secretion
(4) decreased ${\text{K}}^{\text{+}}$ secretion
(5) increased ${\text{HCO}}_3^{-}$ reabsorption
(6) decreased erythropoietin secretion
a. 1,2,3,4,5,6   b. 2,3,4,5  c. 1,2,3,4  d. 1,2,3,4,6  e. 1,2,6