Which are the early (prodromal) clinical manifestations of hepatitis. (Select all that apply).

A. The patient requires painful stimuli to elicit a response and has no purposeful movement: This indicates a severe decrease in consciousness where the patient is minimally responsive, unable to respond to verbal stimuli, and shows no purposeful movement. It reflects significant brain dysfunction and is often seen in severe brain injury or coma.

B. The patient is drowsy but responds to verbal stimuli appropriately: This describes mild to moderate impairment of consciousness, where the patient is lethargic but still able to respond meaningfully to verbal commands, indicating a less severe condition.

C. The patient responds to commands but is slow to do so: A slowed response suggests some cognitive or neurological impairment but not a severe decrease in consciousness. The patient remains alert enough to follow instructions, albeit slowly.

D. The patient can follow simple commands like "open your eyes": This shows the patient is conscious and able to interact, reflecting a mild or normal level of consciousness rather than severe impairment.

A. A 69-year-old female with anemia secondary to insufficient erythropoietin production: While anemia can occur due to chronic kidney disease, it does not directly cause urinary tract obstruction. The lack of erythropoietin affects red blood cell production, not urine flow.

B. A 70-year-old male with benign prostatic hyperplasia (BPH): BPH is a common cause of urinary obstruction in older men. The enlarged prostate compresses the urethra, leading to impaired urine outflow and increased risk of urinary retention.

C. A 58-year-old male with renal calculi: Kidney stones are a frequent cause of urinary tract obstruction. They can block the flow of urine in the ureters, renal pelvis, or bladder, leading to pain, hydronephrosis, and infection risk.

D. A 29-year-old female, pregnant for the first time: Pregnancy can cause urinary obstruction due to the enlarged uterus compressing the ureters, especially in the second and third trimesters, resulting in reduced urine flow and potential hydronephrosis.

E. A 28-year-old male with a neurogenic bladder secondary to spinal cord injury: Neurogenic bladder disrupts normal bladder function and control, which can lead to urinary retention and obstruction due to poor coordination of bladder muscle and sphincter activity.

F. A 43-year-old male with an acid-base imbalance secondary to malnutrition: While malnutrition can affect many organ systems, acid-base imbalance by itself is not a direct cause of urinary tract obstruction.