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A 38-year-old man with a 3-year history of type 2 diabetes mellitus comes to the physician for a follow-up examination. In addition to taking an oral antihyperglycemic agent. he has tried controlling his condition with diet modifications and exercise. He is 188 cm (6 ft 2 in) tall and weighs 113 kg (250
lb); BMI is 32 kg/m3. Physical examination shows no other abnormalities. His hemoglobin A1c is 10%. The physician recommends initiation of insulin injections to obtain better control over the patient's blood glucose concentration. The patient responds. "l know that insulin would help control my blood
sugar. But a lot of people in my family have diabetes. and insulin made them really sick at times." This patient is most likely at which of the following stages of change regarding insulin administration?
A) Precontemplation
B) Contemplation
C) Preparation
D) Action
E) Maintenance
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BB
HE KNOWS he needs to control blood sugar and is willing to take action but he needs more info to clear things about his options
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While lifting weights. a 24-year-old man develops a painful swelling in the right inguinal region that cannot be reduced. The photograph shows a segment of the small intestine resected at exploratory laparotomy. Which of the following is the most likely diagnosis?
A) Adhesions
B) Embolism
C) lntussusception
D) Strangulation
E) Volvulus
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thanks. is the second one D?
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yes stragulated hernia ....incarcerated non reducible i think
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A 38-year-old man is brought to the emergency department 30 minutes alter being found near his home unable to stand upright. He appears lethargic. His pulse is 110/min. and blood pressure is 90/62 mm Hg while supine. Physical examination shows dry mucous membranes and poor skin turgor.
Abdominal examination shows midepigastric tendemess. Laboratory studies show:
Serum
Nat 143 mEq/L
Kr 3.2 mEq/L
Cl- 101 mEq/L
HCO3- 11 mEq/L
Arterial blood gas analysis on room air:
pH 7.28
Poo: 23 mm Hg
Po; 98 mm Hg
Which of the following is the most likely current acid-base status in this patient?
A) Metabolic acidosis
B) Metabolic alkalosis
C) Mixed metabolic acidosis and metabolic alkalosis
D) Mixed respiratory acidosis and metabolic alkalosis
E) Mixed respiratory acidosis and respiratory alkalosis
F) Mixed respiratory alkalosis and metabolic alkalosis
G) Respiratory acidosis
H) Respiratory alkalosis
is it A
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a-high anion gap metabolic acidosis.
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yes its A ..metabolic acidosis ...
thers a little trick which i use in these res met aci alko q
its like 1st look at the ph ,and simelataneously look at pCO2 ... i mean if both the arrow of pH and pCO2 is in same direction either up or either down...then its definetely a METABOLIC cause ...thn ACCORDINGLY name it ....eg: pH arrow if its down its simple its metabolic acidosis n if its up then its metabolic alkolosis .
