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4357 Surgery

A 72-year-old male with diabetes mellitus is evaluated in the emergency room because of lethargy, disorientation, and long, deep breaths (Kussmaul respirations). Initial chemistries on venous blood demonstrate high glucose at 380 mg/dL (normal up to 120) and a pH of 7.3. Recalling the normal bicarbonate (22 to 28 mM) and PCO2 (33 to 45 mmHg) values, which of the additional test results below would be consistent with the man’s pH and breathing pattern?

AA bicarbonate of 5 mM and PCO2 of 10 mmHg
BA bicarbonate of 15 mM and PCO2 of 30 mmHg
CA bicarbonate of 15 mM and PCO2 of 40 mmHg
DA bicarbonate of 20 mM and PCO2 of 45 mmHg
Surgery
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4359 Surgery

A 28-year-old G1P0 presents to your office at 18 weeks gestational age for an unscheduled visit secondary to right-sided groin pain. She describes the pain as sharp and occuring with movement and exercise. She denies any change in urinary or bowel habits. She also denies any fever or chills. The application of a heating pad helps allete the discomfo. As her obstetrician, what do you tell this patient is the most likely etiology of this pain?

ARound ligament pain
BAppendicitis
CKidney stone
DUrinary tract infection
Surgery
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4362 Surgery

A 70 year old man comes to clinical attention with progressive memory loss, urinary incontinence, and gait instability. MRI of the brain shows dilatation of the ventricular cavities, while the cerebral coex appears normal. No infarcts are seen. Repeated lumbar punctures reveal occasional increases in cerebrospinal fluid (CSF) pressure. A biopsy of the frontal coex demonstrates the absence of neurofibrillary tangles and senile plaques. Which of the following is the most appropriate treatment?

AAcetylcholinesterase inhibitors such as tacrine
BAspirin
CL-DOPA
DVentricular shunt
Surgery
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