A 42 year old man reports to his physician for annual physical examination. He is 5'8" and weighs 240 pounds with a skin fold test revealing 33% body fat composition. The patient complains of recent episodes of waking up in the middle of the night with the urge to urinate. Further questioning reveals he has also been thirstier than normal. Laboratory analysis reveals a random plasma glucose level of 160 mg/dL and hemoglobin A1c of 7.2%. His physician orders further testing and it is found that his C-peptide level is normal. What type of diabetes would this patient have? O Type 1 O Type 2 O Gestational Other
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- Mr. B is a 57-year-old man who was admitted yesterday after starting to pass black stools. He has a two-day history of severe stomach pains and has suffered on and off with indigestion for some months. He is a life-long smoker, with mild chronic heart failure (CHF) for which he has been taking enalapril 5 mg twice daily for 2 years. He also recently started taking naproxen 500 mg twice daily for arthritis. He works a stressful job and drinks large amounts of caffeinated coffee daily. Yesterday his hemoglobin was reported as 9.3 g/dL, hematoocrit 30%, RBC's 3.2, platelets 162, INR 1.1 with Liver Function Test normal. He was mildly tachycardic (110 bpm) and had a slightly low blood pressure of 100/77 mmHg and was given 1.5 L of saline. He has just returned from an endoscopy this morning and has been newly diagnosed as having a bleeding duodenal ulcer. They took a biopsy to determine if he is positive for H-pylori. He has been written up for his usual medication for tomorrow if he is…An 85-year-old female with history of hypertension presented with cough and low-grade fever. Chest radiography is consistent with a diagnosis of pneumonia. The doctor ordered the antibiotic Levofloxacin 500 mg PO X 10 days. The patient's blood work came back, and basic metabolic panel showed potassium (K) of 5 mmol/L, sodium (NA) 140 mmol/L, glucose of 115, BUN of 19 mg/dl and creatinine of 1.2 mg/dl. Questions: 1. In your understanding of the physiological changes in the elderly, what predisposes them to respiratory infections?A 57 year-old male patient who has a longstanding history of hypertension, type 2 diabetes and hyperlipidemia. He presents with a chief complaint of nausea, shortness of breath, lower extremity edema and abdominal swelling. He is 5 feet and 6 inches tall and weighs 77.7 kilograms (Body Surface Area: 1.90). His blood pressure is 165/92 mmHg, heart rate is 97 beats per minute. Blood has drawn and urine is collected for various clinical chemistry tests. Laboratory Data Urine Creatinine: 88 mg/dL Urine Volume: 3,777 mL/24 hrs Plasma Creatinine: 4.75 mg/dL Urea Nitrogen: 170 mg/dL Blood Uric Acid 11.7 mg/dL Questions: 1. Given these data, what is the Creatinine Clearance of this patient? What are the possibilities for his lower extremity edema? What is/are the probable cause/s for the elevated Creatinine and Urea N? 2. 3.
- A 40yo male presents to the emergency department with the chief complaint of shortness of breath (SOB). His past medical history (MHx) is remarkable for hypertension (HTN) and diabetes mellitus II (DMII). On examination, his oxygen saturation on room air is 87%, blood pressure 160/100 mmHg, and pulse rate is 93/min. His arterial blood gas on room air shows pH 7.44, PCO2 35 mmHg, PO2 55 mmHg. Assume that the RQ is 0.8. Given arterial pO2 and alveolar pO2, the following disease states are plausible... Group of answer choices Hypoxic hypoxia Ischemic/Stagnant hypoxia Histotoxic hypoxia Normal ventilation/perfusionA 40yo male presents to the emergency department with the chief complaint of shortness of breath (SOB). His past medical history (MHx) is remarkable for hypertension (HTN) and diabetes mellitus II (DMII). On examination, his oxygen saturation on room air is 87%, blood pressure 160/100 mmHg, and pulse rate is 93/min. His arterial blood gas on room air shows pH 7.44, PCO2 35 mmHg, PO2 55 mmHg. Determine the alveolar gas pressure. Assume that the RQ is 0.8. A. 52 B. 22 C. 107 D. 200A 40yo male presents to the emergency department with the chief complaint of shortness of breath (SOB). His past medical history (MHx) is remarkable for hypertension (HTN) and diabetes mellitus II (DMII). On examination, his oxygen saturation on room air is 87%, blood pressure 160/100 mmHg, and pulse rate is 93/min. His arterial blood gas on room air shows pH 7.44, PCO2 35 mmHg, PO2 55 mmHg. Assume that the RQ is 0.8. Based on your calculations, what should the arterial blood gas be?
- Mehmet Yavuz is 62 yo. He presented to the clinic and after having an HbA1c test (result 9%) was diagnosed with type 2 Diabetes mellitus.His cardiovascular risk was > 15%. His renal health screen showed an eGFR 90 mL/min/1.73m2 with microalbuminuria of 3.5 mg/mmol.He attended a podiatry appointment which detected decreased dorsalis pedis and posterior tibialis pulses in both legs . Management of his condition now includes the following: Exercise: at least 150 minutes of aerobic and 60 minutes of resistance exercise each week Diet: a plan worked out with an accredited dietician based on the Australian Dietary Guidelines (2013). Drug use: smoking cessation plan to stop cigarette use; alcohol consumption reduction to 1 - 2 full strength beers every second day Weight loss: Mehmet aims to lose 5 kg over the first 6 - 8 weeks after diagnosis. Medications: Jardiamet (empagliflozin 5mg, metformin 500 mg), twice daily, with or after food ramipril 5 mg, daily Rosuzet (rosuvastatin 20mg,…Mehmet Yavuz is 62 yo. He presented to the clinic and after having an HbA1c test (result 9%) was diagnosed with type 2 Diabetes mellitus.His cardiovascular risk was > 15%. His renal health screen showed an eGFR 90 mL/min/1.73m2 with microalbuminuria of 3.5 mg/mmol.He attended a podiatry appointment which detected decreased dorsalis pedis and posterior tibialis pulses in both legs . Management of his condition now includes the following: Exercise: at least 150 minutes of aerobic and 60 minutes of resistance exercise each week Diet: a plan worked out with an accredited dietician based on the Australian Dietary Guidelines (2013). Drug use: smoking cessation plan to stop cigarette use; alcohol consumption reduction to 1 - 2 full strength beers every second day Weight loss: Mehmet aims to lose 5 kg over the first 6 - 8 weeks after diagnosis. Medications: Jardiamet (empagliflozin 5mg, metformin 500 mg), twice daily, with or after food ramipril 5 mg, daily Rosuzet (rosuvastatin 20mg,…Mehmet Yavuz is 62 yo. He presented to the clinic and after having an HbA1c test (result 9%) was diagnosed with type 2 Diabetes mellitus. His cardiovascular risk was > 15% His renal health screen showed an eGFR 90 mL/min/1.73m2 with microalbuminuria of 3.5 mg/mmol. He attended a podiatry appointment which detected decreased dorsalis pedis and posterior tibialis pulses in both legs . Management of his condition now includes the following: Exercise: at least 150 minutes of aerobic and 60 minutes of resistance exercise each week Diet: a plan worked out with an accredited dietician based on the Australian Dietary Guidelines (2013). Drug use: smoking cessation plan to stop cigarette use; alcohol consumption reduction to 1 - 2 full strength beers every second day Weight loss: Mehmet aims to lose 5 kg over the first 6 - 8 weeks after diagnosis Medications: Jardiamet (empagliflozin 5mg, metformin 500 mg), twice daily, with or after food ramipril 5 mg, daily Rosuzet (rosuvastatin…
- Mehmet Yavuz is 62 yo. He presented to the clinic and after having an HbA1c test (result 9%) was diagnosed with type 2 Diabetes mellitus.His cardiovascular risk was > 15%. His renal health screen showed an eGFR 90 mL/min/1.73m2 with microalbuminuria of 3.5 mg/mmol.He attended a podiatry appointment which detected decreased dorsalis pedis and posterior tibialis pulses in both legs . Management of his condition now includes the following: Exercise: at least 150 minutes of aerobic and 60 minutes of resistance exercise each week Diet: a plan worked out with an accredited dietician based on the Australian Dietary Guidelines (2013). Drug use: smoking cessation plan to stop cigarette use; alcohol consumption reduction to 1 - 2 full strength beers every second day Weight loss: Mehmet aims to lose 5 kg over the first 6 - 8 weeks after diagnosis. Medications: Jardiamet (empagliflozin 5mg, metformin 500 mg), twice daily, with or after food ramipril 5 mg, daily Rosuzet (rosuvastatin 20mg,…Given E.B.'s diagnosis, her physician ordered blood glucose screening. The results of these tests are shown below: Blood Glucose Screening Tost E.B. Lovels Glucose Fasting blood glucose 2-hour oral glucose tolerance test 142 mg/dL 188 mg/dL 70-99 mg/dL <140 mg/dL Fasting Insulin 2-hour Insulin oral glucose tolerance test 15.2 miU/ml 82 mlU/ml <10 miU/ml 6-50 mlU/ml 5 Examine EB.'s blood glucose and insulin tests, What do these results indicate about EB.'x ability of her body to produce and respond to Insulin and her body's abnty to regulate blood glucose? 6 Rescarch the refationship between insulin gonadotropina and androgens How might EB's abnormal insulin levels contribute to changes In gonadotropin and androgen production? In order to increase E.B.s chances of becoming pregnant her physician has E.B. perform the following. Inducing menstruation: Provera (progesterone) is given for 5 to 10 days at a dose of 5 or 10 mg daly. The period usually starts within 2-7 days after the last…James Dunn is a 40-year-old African American man. He presents to the physician’s office today complaining of headache. His vital signs during triage are as follows: blood pressure 165/90 mm Hg, heart rate 80 beats/minute, temperature 98.5F, weight 125 kg (275 lb), and height 5 ft 11 in. He currently has no other diagnosed medical conditions. The physician gives Mr. Dunn a prescription for lisinopril/hydrochlorothiazide (Prinzide) 10/12.5 mg with directions to take one tablet by mouth daily in the morning. (Learning Objectives 1, 3, 4, 8) 1. In which stage of hypertension would you place Mr. Dunn? 2. What lifestyle modifications should Mr. Dunn be encouraged to follow? 3. What class of antihypertensive is lisinopril/hydrochlorothiazide? 4. What would you tell Mr. Dunn about his new medication?