65. A 45-year-old man with a history of type 2 diabetes mellitus, alcoholism, and liver dis develops fever, severe headache, and vomiting over the course of 12 hours. Physica examination shows nuchal rigidity. A lumbar puncture is done. Laboratory studies sh 180 mg/dL Serum glucose Cerebrospinal fluid Neutrophils A) Ceftriaxone B) Clindamycin C) Erythromycin OD) Gentamicin E) Nafcillin Which of the following is the most appropriate pharmacotherapy? -2 1 1 Protein Glucose Culture X 300/mm3 100 mg/dL 25 mg/dL gram-positive diplococci nuchal ility
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- 31. A 6-year-old boy is brought to the physician by his mother because of intermittent upper abdominal pain during the past 5 weeks and a rash for 1 week. Vital signs are norma Physical examination shows yellow nodules over the extensor surfaces of the upper extremities. There is hepatomegaly and tenderness on palpation of the epigastric regior Serum studies show an increased amylase activity, increased chylomicron concentration, and a markedly increased triglyceride concentration. Three months after beginning restricted diet, his serum chylomicron and triglyceride concentrations decrease significantly, and the skin lesions resolve. A deficiency of which of the following enzymes is likely cause of these findings? O A) Acetyl-CoA carboxylase O B) HMG-CoA lyase O C) HMG-CoA reductase O D) Hormone-sensitive lipase O E) Lipoprotein lipaseII. Apatient cametoatherapist with complaintsofprogressive weakness, drowsiness, dizziness. Symptoms were intensifying during fasting that allowed the doctor to suggest hypoglycemia in the patient. Additional screening (glucose level was less than 2.5 mmol/A, C-peptide level significantly increased) confirmed the initial assumption. The patient does not suffer from diabetes and does not take sugar-lowering drugs. What possible cause of the disease can be assumed in the patient? What hormone seeretion is increased in such patient? What is the danger of hypoglycemia? What processes in the body prevents the hypoglycemia even during fasting in healthy person?pathophysiology A client is on complete bed rest after a total hip replacement surgery while he is being treated for a mild postoperative surgical wound infection. Identify the underlying physiologic factors that could increase the nutritional needs of this client. give scientific rational A.Anabolism, polydipsia, hypertriglyceridemia B.Elevated protein plasma levels, hypotension, glycolysis C.Large abdominal girth, insulin resistance, acidosis Fever, increased white blood cell count, negative nitrogen plasma level
- A 56-year old maintenance worker, with a past medical history of insulin dependent diabetes, CHF, and hypertension, presents to the emergency room with lightheadedness, lethargy, and periods of confusion. Patient family members found him unconscious outside. Wife states, “he’s been at it for over a weeknow” Medications: Insulin, Lasix, Digoxin and Vasotec: were:Temperature Pulse Respirations36.7C 118 18On examination, the patient has slurred speech with decreased upper and lower motor strength bilaterally 4/5. While examining the patient, he experienced loss of consciousness that lasted less than half a minute. The nurse, drew labs, administered oxygen via NC, Established IV line access and placed patient on a monitor. Lab resultsVitals on admission Blood Pressure 103/61 Electrolytes – in emergency room Hematocrit –PotassiumSodiumPhosphorus 2.6 mg/dL BicarbonateCalciumCreatinineSerum Osmolarity Glucose38%3.3 mEQ/L147 mEQ/L21 mEq/L 7.6 mg/dL2.4 mg/dL321 mmol/kg 389 mg/dL…84.A35-year-oldmancomestothe physician becauseof a 3-dayhistory of tingling inhis fingers and muscle cramps. Tapping overthe facial nerve produces ipsilateral contraction of the faciai muscles. His serum calcium concentration is 7.2 mg/dl. Serum concentrations of vitamin D and 25-hydroxycholecalciferol are within the reference range; serum 1,25-dihydroxycholecalciferol concentration is 5 pg/ml (N=18-65). Disease inwhich of the following is the most likely cause ofthis patient's findings? A) Bone B) Gut C) Kidney D) Liver E) Lungs F) Skin43. A 13 year old boy with type 1 diabetes mellitus is brought to the emergency department because of nausea and weakness for 24 hours. He did not take his last 3 doses of insulin. His temperature is 37C(98.6F), pulse is 120/min, respirations are 30/min, and blood pressure is 90/60 mm Hg. Physical examination shows dry mucous membranes and decreased skin turgor. Laboratory studies show: Serum HCO3 Glucose Arterial blood gas analysis on room air: pH PCO2 6 mEq/L 400 mg/dL a. Buffering by HCO3 b. Buffering by inorganic phosphates c. Buffering by intracellular proteins d. Increased renal excretion of titratable acid e. Pulmonary excretion of CO2 derived from HCO3 7.10 20 mm Hg Which of the following processes is the initial defense against the decrease in arterial pH in this patient?
- The number of tablets required to fulfil the following prescription: Prednisolone 5 mg e/c tabletsTake 25 mg daily for 4 days, then reduce by 5 mg every 4 days until the course is * finished (total course: 20 days)Orotic aciduria is treated with: O Tetrahydrofolate 5-flourouricil Uridine supplements Calcium hydroxylateA 35-year-old woman became severely depressed after the sudden death of her husband. Twomonths later, she was brought to the emergency room by her friend because of extremeweakness and lethargy. She appeared thin and pale. Upon history taking, the doctor found thatshe had not eaten for several weeks. Analysis of the plasma sample indicated elevated levels ofalanine, acetoacetate, β-hydroxybutyrate and blood urea nitrogen (BUN). However, her plasmaglucose concentration was low (55mg/dL). She was hospitalized, given intravenous feeding,antidepressant medications and subsequently shifted to a 1800kCal (7500kJ) diet. Her recoverywas uneventful.3.a) How could the patient maintain her plasma glucose levels within normal limits even though shewas not eating?b
- Sex : MaleAge : 40 yearsHeight : 5 feet 7 inchesWeight : 60 kgActivity : sedentary lifestyleClinical pictureHis blood picture is (values are in mg/dl):Haemoglobin 10.5Creatinine 2.0Urea Nitrogen 35.0Uric acid 7.8Total protein 6.9Albumin 3.9Serum calcium 8.7Sodium 141Potassium 5.1Chloride 106 Plan a day's diet for him. Mention nutrients that need special emphasis, Also list out do's and don'ts.Pt is 69 years old male, complaining of dizziness, falls and getting up to use the bathroom at night. Recently dx with BPH and ED. Has SULFA allergies. Vitals - BP:112/66 TSA: 3.0 HTN - Lisinopril 10mg Hypothyroidism - Levothyroxine 50mcg BPH - Doxazosin 2mg Can I give Finastiride and Viagra to help with BPH and ED symptoms?A 6-year-old boy is brought to the physician by his mother because of intermittent upper abdominal pain during the past 5 weeks and a rash for 1 week. Vital signs are normal. Physical examination shows yellow nodules over the extensor surfaces of the upper extremities. There's hepatomegaly and tenderness on palpation of the epigastric region. Serum studies show an increased amylase activity, increased chylomicron concentration, and a markedly increased triglyceride concentration. 3 months after beginning a fat-restricted diet, his serum chylomicron and triglyceride concentration decreased significantly, and the skin lesions resolve. A deficiency of which of the following enzymes is the most likely cause of these findings? a. Acetyl-CoA carboxylase b. HMG-CoA lyase c. HMG-CoA reductase d. Hormone-sensitive lipase e. Lipoprotein lipase