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5077 Medicine

A 40-year-old female brought to causality by her husband with c/o decreased mental status. She had a knee surgery 3 days back for pain she’s taking oral oxycodone. Her husband noted that she finished the 7 days’ supply during that day only. Patient repoed no seizure activity and there is no H/O of intake of any other drug. On examination patient is afebrile. blood pressure 120/80 mm Hg, Respiratory rate is 3 breath /min with Spo2 = 82%. Patient do not respond to painful stimuli but is able to move all the four extremities. Which of the following drug will you prescribe to improve her mental status?

AAlbuterol
BFlumazenil
CAlvimopan
DNaloxone
Medicine
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5083 Medicine

A 74-year-old man presents to the clinic for assessment of symptoms of fatigue, shortness of breath on exertion, and back and rib pain that is made worse with movement. Investigations reveal he is anemic, the calcium, urea, and creatinine are elevated. X-rays reveal multiple lytic lesions in the long bones and ribs, and protein electrophoresis is positive for an immunoglobulin G (IgG) paraprotein. Which of the following is the most likely mechanism for the renal injury?

Aplasma cell infiltrates
Btubular damage by light chains
Cglomerular injury
Dvascular injury by light chains
Medicine
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