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(27) An 80-year old man witha 20-year old history of ashthma comes to the physician because of a 24 hour history of a running nose , sore throat , cough,muscle aches, and fatigue. His temperature is 39.5 degrees celcius (103.1F). Zanamivir is prescribed because it inhibits which of the following enzymes?
(A) Aldolase
(B) Kinase
(C) N-acetyl glucosaminidase
(D) Neuraminidase
(E) Transglycosylase
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- A client with Type 1 diabetes mellitus is admitted to the hospital in a semi-conscious state with fever, nausea, and vomiting. The urine sample was positive for ketone bodies. Which of the following statements regarding the client is correct? Question 80 options: a) Glucagon should be administered to stimulate glycogenolysis and gluconeogenesis in the liver b) An injection of insulin will decrease ketone-body production c) The client should be started on a glucose infusion to help them regain consciousness d) The client's blood glucose level is well below 4.4 mmol/LWhich of the following are priorities in the acute management of DKA and HHNKS? Question 74 options: a) Long-acting IV insulin to correct glucose over a longer period of time and to prevent cerebral edema, neurovitals every hour to monitor neurological status b) Fluid rehydration, correction of hyperglycemia, monitoring and correcting electrolytes c) Mannitol or 3% saline to prevent cerebral edema as part of fluid rehydration, sodium bicarbonate for metabolic acidosis, correction of hypokalemia d) Gradual fluid rehydration, aggressive correction of hyperglycemia, and correcting sodium levelsBaby Joan has been diagnosed with gastroesophageal reflux disease and placed on metoclopramide (Reglan). Her mother calls the clinic because she does not think the medication is helping and feels that Joan has developed loose stools.a. What are the therapeutic actions of metoclopramide? What are the most common adverse effects of metoclopramide, and when should Joan’s mother worry?
- Extrapyramidal side effects of antipsychotic medications include: Question 48 options: a) Weight gain, obesity and increased prolactin levels b) Dystonia and tardive dyskinesia c) Anxiety and sweating d) Depression and sexual dysfunctionWhich of the following is true about the pathophysiology of hypoglycemia? Question 62 options: a) Glucagon decreases glycogenolysis and gluconeogenesis in the liver b) Autonomic symptoms are caused by increased levels of glucagon which then stimulates the hypothalamic-pituitary-adrenal axis c) Beta cells suppress insulin secretion at a plasma glucose level of 3 mmol/L d) Abrupt cessation of glucose delivery to the brain results in confusion, drowsiness, vision changes, and headacheWhich of the following is a clinical manifestation consistent with diabetic ketoacidosis? Question 63 options: a) Glucose < 14 mmol/L b) pH > 7.51 c) Bicarbonate > 30 mmol/L d) Acetone breath
- Which of the following describes a feature of the pathophysiology of type 2 diabetes? Question 15 options: a) It is usually an autoimmune disease b) The pancreas makes little or no insulin c) Diabetic ketoacidosis is a common complication d) The liver increases production of glucoseDKA and HHNKS are described as: Question 3 options: a) Life threatening hyperglycemic emergencies requiring immediate care b) Temporary hyperglycemic crises that require doubling up on insulin dose c) Chronic illness that causes nephropathy in the long-term d) Acid-base imbalance disorders, specifically metabolic acidosisAn unresponsive client who has diabetes is brought to the emergency department with rapid, deep respirations. Additional findings include: blood glucose 24.9 mmol/L, arterial pH 7.2 and urinalysis showing presence of ketones and glucose. Which of the following statements best describes the underlying cause of this patient’s presentation? Question 64 options: a) Relative insulin deficiency, causing hyperglycemia, oxidative stress, renal dysfunction and acidosis b) Nocturnal elevation of growth hormone resulting in hyperglycemia in the morning c) Absolute insulin deficiency, increased counter-regulatory hormone, lipolysis and free fatty acid release d) Hypoglycemia causes release of glucagon, resulting in glycogenolysis and hyperglycemia
- A client with T2DM is admitted to the medical unit with pneumonia. The client’s oral antidiabetic medication has been discontinued and the patient is now receiving insulin for glucose control. Which of the following statements best explains the rationale for this change in medication? Question 73 options: a) Insulin administration will help prevent hypoglycemia during the illness b) Acute illnesses like pneumonia will cause increased insulin resistance c) Infection has compromised beta cell function so the client will need insulin from now on d) Stress-related conditions such as infections induce a hypermetabolic stateWhat is the most common cause of mortality in those with diabetes mellitus? Question 76 options: a) Renal failure b) Myocardial infarct and stroke c) Gangrene and sepsis d) Autonomic and somatic neuropathyThe pathophysiology of chronic diabetic complications is related to which process? Question 65 options: a) Oxidative stress and ROS have a limited role in the pathophysiology of diabetes mellitus b) Sorbitol and fructose are products of the polyol pathway that accumulate and reduce intracellular osmotic pressure causing cellular injury c) AGEs are formed by the irreversible binding of glucose to proteins, lipids and nucleic acids d) The hexosamine pathway causes pathologic changes in gene expression associated with increased insulin activity and improved cardiovascular health