Patient M, 72 y/o, is in the intensive care unit with the symptoms of dehydration, oliguria, hypothermia, hypoxemia (hypoxia). In the anamnesis there is a record of type 2 diabetes mellitus treated with biguanides. Her condition began to deteriorate after she had a myocardial infarction one month ago. Objectively: the skin is dry; turgor is lowered, arterial pressure – 80/40 mm column of mercury, pulse – 136beats/minute. The breathing is shallow, eye ball tone is lowered. What is your diagnosis?A. Hyperlactacidemic comaB. Uremic comaC. Ketoacidotic comaD. Brain comaE. Hyperosmolar coma
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Patient M, 72 y/o, is in the intensive care unit with the symptoms of dehydration, oliguria, hypothermia, hypoxemia (hypoxia). In the anamnesis there is a record of type 2 diabetes mellitus treated with biguanides. Her condition began to deteriorate after she had a myocardial infarction
one month ago. Objectively: the skin is dry; turgor is lowered, arterial pressure – 80/40 mm column of mercury, pulse – 136beats/minute. The breathing is shallow, eye ball tone is lowered.
What is your diagnosis?
A. Hyperlactacidemic coma
B. Uremic coma
C. Ketoacidotic coma
D. Brain coma
E. Hyperosmolar coma
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- Patient M., 36 y/o, was found in the street unconscious. The patient has a medical history of diabetes. There is a smell of alcohol from the mouth. The skin is moist, warm, arterial pressure -145/90 mm column of mercury, convulsive twitching of muscles. Breathing is shallow, eye ball tone is retained, pupils are dilated, hyperflexion. How would you treat this patients?A. Intravenous introduction of 40-80-100 ml 40% glucose solution B. Injecting 20 units of insulin subcutaneouslyC. Injecting 20 units of insulin intravenouslyD. Injecting 500 ml 5% glucose solution intravenouslyE. Injecting 500 ml 0.9% sodium chloride intravenouslyMr. 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…Situation: Mrs. Corona was diagnosed of Diabetes Mellitus Type II. She was admitted to the Emergency due to dizziness, headache frequency of urination at night and complained of very hungry. Her weight suddenly decreases for the past months from 140 lbs to 110 lbs also feeling tired and having dry skin. She sought admission due to the following signs and symptoms. Her hemogluco test (blood sugar) level is from 180 - 200mg / dl 2 hours after eating. The best and correct ecologic model for Mrs. Corona? a. Web Model b. Triangle model c. Wheel model d. All the choices
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