Thread Rating:
  • 0 Vote(s) - 0 Average
  • 1
  • 2
  • 3
  • 4
  • 5
nbme 1 - rizowana
#11
dec. sodium may b beneficial but why u wan to cut off her calorie .already on 10 percentile for wt.

she developed crf as a complication of post strep GN, low protein wil dec. her kidney work load.

lines from renal resource web.

As part of the medical treatment for your kidneys, you may have been advised to follow a low protein diet. Protein in the food we eat is converted by the liver into urea and other toxins which are normally removed from the body in the urine. These substances accumulate if the kidneys are damaged.

In the early stages of kidney damage, a high protein intake may cause the kidneys to overwork - hyperfiltration - leading to damage of the kidney filters. In the later stages, the build up of toxins can contribute to symptoms of kidney failure such as nausea, tiredness, easy bruising and bleeding. A reduction in dietary protein can help to reduce early kidney damage in some cases and the symptoms associated with more severe kidney failure. There are other very important factors which can speed up kidney damage. High blood pressure, smoking, high blood cholesterol and high blood sugar levels in people with diabetes, are amongst these.

nothing related to low calorie diet..
dec sodium is imp but
low sodium has not much impact on b.p...2-8 mmhg (as i remem)
she is not particularly hypertensive .but her bun is 50.....
Reply
#12
THANK YOU SAD.(BE HAPPYSmile
Reply
#13
ohh m not actually sad...its initial of my name...
u r most welcome.....
Reply
#14
19. A 4-year-old boy is brought to the emergency department 20 minutes after being involved in a motor vehicle collision. He was an unrestrained passenger. On arrival, his blood pressure is 110/70 mm Hg, pulse is 100/min, and respirations are 32/min with grunting and retractions. Examination shows multiple bruises over the chest. Arterial blood gas analysis while breathing 40% oxygen shows:

pH 7.38
PCO2 34 mm Hg
PO2 66 mm Hg

An x-ray film of the chest obtained 4 hours later shows diffuse infiltrates on the right side. Which of the following is the most likely diagnosis?

A
) Acute respiratory distress syndrome

B
) Aspiration pneumonia

C
) Fat embolism

D
) Hemothorax

E
) Pulmonary contusion

Reply
#15
I agree with all the previous answers, hope we r right!!!!

the last one I would choose E
Reply
#16
23. A 55-year-old man has had crushing substernal chest pain on exertion over the past 6 weeks. He had a myocardial infarction 2 months ago. He takes nitroglycerin as needed and one aspirin daily. He has smoked two packs of cigarettes daily for 30 years. Examination shows normal heart sounds and no carotid or femoral bruits. Treatment with a β-adrenergic blocking agent is most likely to improve his symptoms due to which of the following mechanisms?

A
) Decreasing diastolic relaxation

B
) Decreasing myocardial contractility

C
) Dilating the coronary arteries

D
) Peripheral vasodilation

E
) Preventing fibrin and platelet plugs

Reply
#17
BB
Reply
#18
15. A 28-year-old man is brought to the emergency department by police because of severe pain in the right lower quadrant of the abdomen for 36 hours. He has been incarcerated in the county jail, and his court hearing is scheduled in 12 hours. He takes no medications. Abdominal examination shows no rebound. Complete blood count, liver tests, and erythrocyte sedimentation rate are within normal limits. An x-ray film of the abdomen shows a normal gas pattern. Test of the stool for occult blood is negative. Which of the following is the most likely diagnosis?

A ) Adjustment disorder

B ) Conversion disorder

C ) Depressive disorder not otherwise specified

D ) Factitious disorder

E ) Hypochondriasis

F ) Malingering

G ) Somatization disorder
Reply
#19
FF....secondary gain
Reply
#20
17. A previously healthy 62-year-old man comes to the emergency department because of abdominal pain for 48 hours. His temperature is 38.6 C (101.5 F), blood pressure is 130/80 mm Hg, pulse is 110/min, and respirations are 15/min. Abdominal examination shows diffuse left lower quadrant tenderness with no peritoneal signs. Rectal examination shows no abnormalities; test of the stool for occult blood is negative. His leukocyte count is 14,700/mm3. Which of the following is the most appropriate next step in diagnosis?

A
) Barium enema

B
) CT scan of the abdomen

C
) Colonoscopy

D
) Cystoscopy

E
) Exploratory laparotomy
Reply
« Next Oldest | Next Newest »


Forum Jump: