03-17-2012, 03:19 PM
Q1 A 16year old boy has a 6 month history of type 1 diabetes mellitus and requires daily insulin injections. his blood glucose control has been poor recently, which the physician suspects may be related to the pt's rluctance to self administer insulin. which of the following questions is most appropriate to broach this issue with the pt?
A> givin yourself insulin injections can be difficult. what's it like for you?
B> i get the feeling you have not been taking your insulin regularly. would you like me to arrange some training for you by our nurses?
C> its been my experience that most poorly controlled diabetics have trouble giving themselves insulin. do you have this problem?
D> you are clearly having difficulty with insulin injections. would you like to arrange for a family member to give you your shots?
E> you seem to have missed your shots. how often has this happend?
Q2 an investigator breeds a transgenic strain of mice that develops severe fasting hypoglycemia. administration of glucagon does not correct the hypoglycemia, but administration of epinephrine results in an inc in the serum glucose conc. which of the following proteins is most likely defective in this mouse strain?
A> adenylyl cyclase
B> glucagon recepter
C> glycogen phosphorylase (wrong)
D> heterotrimeric G protein
E> phosphorylase kinase
F> protein kinase A
A 25 year old woman comes to the physician because of a 2-day history of dec urine output despite ample fluid intake. she underwent operative removal of a perforated appendix 3 weeks ago. she received intravenous gentamicin for 2 wks. physical examination shows no abnormalities. lab studies show.
Serum:
urea nitroge: 35mg/dl
creatinine: 2.9md/dl
urine:
specific gravity 1.010
protein 2+
Na+ 25mEq/L
casts brown granula
Histologic examination of this pts kidneys would most likely show necrotic cells in which of the following components of the nephron?
a. bowman capsule
b.collecting tubule
c. glomerular basement membrance
d.mesangium
e. proximal tubule
A> givin yourself insulin injections can be difficult. what's it like for you?
B> i get the feeling you have not been taking your insulin regularly. would you like me to arrange some training for you by our nurses?
C> its been my experience that most poorly controlled diabetics have trouble giving themselves insulin. do you have this problem?
D> you are clearly having difficulty with insulin injections. would you like to arrange for a family member to give you your shots?
E> you seem to have missed your shots. how often has this happend?
Q2 an investigator breeds a transgenic strain of mice that develops severe fasting hypoglycemia. administration of glucagon does not correct the hypoglycemia, but administration of epinephrine results in an inc in the serum glucose conc. which of the following proteins is most likely defective in this mouse strain?
A> adenylyl cyclase
B> glucagon recepter
C> glycogen phosphorylase (wrong)
D> heterotrimeric G protein
E> phosphorylase kinase
F> protein kinase A
A 25 year old woman comes to the physician because of a 2-day history of dec urine output despite ample fluid intake. she underwent operative removal of a perforated appendix 3 weeks ago. she received intravenous gentamicin for 2 wks. physical examination shows no abnormalities. lab studies show.
Serum:
urea nitroge: 35mg/dl
creatinine: 2.9md/dl
urine:
specific gravity 1.010
protein 2+
Na+ 25mEq/L
casts brown granula
Histologic examination of this pts kidneys would most likely show necrotic cells in which of the following components of the nephron?
a. bowman capsule
b.collecting tubule
c. glomerular basement membrance
d.mesangium
e. proximal tubule