nbme 6 qs, please answer with explanation.thanks - dextermorgan

[ArchivalUser]

52 y/o 3-month history of increased urinary volume and frequency with 15 pound weight loss despite normal appetite with family history of HTN and type 2 diabetes. He is obese and BP 160/85. NONfasting glucose is 280. Which of the following is increased?

A. bicarbonate
B. glucagon
C. HDL
D. Insulin
E. Ketones

[ArchivalUser]

Four hours after undergoing a cesarean delivery at term followed by tubal ligation, a 37-year-old
woman, gravida 2, para 2, has dizziness and confusion. The operation was uncomplicated, and
blood loss is estimated to be 800 mL. Patient-controlled epidural analgesia has been moderately
effective for pain. Her blood pressure now is 80/40 mm Hg, decreased from 120/72 mm Hg
intraoperatively, and pulse is 152/min, increased from 96/min intraoperatively. Breath sounds are
decreased bilaterally. No murmurs are heard. Abdominal examination shows distention and
tenderness. Bowel sounds are absent. The incision is intact with no drainage. She is disoriented to
person, place, and time. Her hematocrit is 23%; preoperative hematocrit was 35%. Which of the
following is the most likely cause of the hemodynamic changes?
A
) Epidural-related hypotension
B
) Insufficient intraoperative fluid replacement
C
) Postoperative intra-abdominal hemorrhage
D
) Supine hypotensive syndrome
E
) Underestimated intraoperative blood loss

[ArchivalUser]

A 52 yo woman comes to the physician because of decreased libido; this symptom began 8 months ago, after she underwent a total abdominal hysterectomy and bilateral salpingo-oophorectomy for leiomyomata uteri and menorrhagia. She has been taking hormone replacement therapy with conjugated estrogen since the operation. Examination shows a moist, rugated vagina. Which of the following is the most likely cause of these findings?

a. decreased androgens
b. decreased estrogen
c. decreased FSH
d. decreased LH
e. decreased progesterone
f. decreased prolactin
g. increased androgens
h. increased estrogen (wrong)
i. increased FSH
j. increased LH
k. increased progesterone
l. increased prolactin

[ArchivalUser]

52 y/o 3-month history of increased urinary volume:
D: Insulin is elevated. Patient has type 2 diabetes which is characterized by insulin resistance.


Four hours after undergoing a cesarean delivery:
C: Post-operative Hemorrhage. Patient was previously hemodynamically stable during the procedure, and now is not with a distended tender abdomen, no bowel sounds because intestines are irritated by the blood in the peritoneal cavity.

A 52 yo woman comes to the physician because of decreased libido:
A: Decreased androgens. Androgens are related to libido, she is receiving enough estrogen (as evidenced by her rugation), but not enough androgens for a healthy libido.