A patient with diabetes mellitus (DM) developed a serum glucose of 900 and an elevated serum osmolality. The patient then became unconscious. What pathological process most likely caused the altered neurologic status?

The brain cells became edematous because of a blood to tissue shift of fluid.

Hyperinsulinemia caused hypoglycemia and a tonic clonic seizure.

The brain cells became dehydrated because of fluid shirting out of the cells.

Fluid volume overload caused higher pressure in the brain tissue

Answer and Explanation

The Correct Answer is C

A. The brain cells became edematous because of a blood to tissue shift of fluid: This describes cerebral edema, which is not typically caused by hyperglycemia.

B. Hyperinsulinemia caused hypoglycemia and a tonic-clonic seizure: The scenario describes hyperglycemia, not hypoglycemia.

C. The brain cells became dehydrated because of fluid shifting out of the cells:. In hyperglycemic hyperosmolar syndrome (HHS), extremely high blood glucose leads to increased serum osmolality, causing water to move out of brain cells, leading to dehydration and altered consciousness.

D. Fluid volume overload caused higher pressure in the brain tissue: Fluid volume overload is not the primary issue in this scenario; rather, dehydration is the concern due to hyperglycemia.

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Correct Answer is A

Explanation

A. Decrease osteoclastic activity: Osteoporosis treatments often focus on reducing osteoclastic activity, which is responsible for bone resorption, thereby helping to maintain or increase bone density.

B. Increase the kidneys' tubular secretion of calcium into the urine: This would decrease calcium levels in the body, which is not desired in osteoporosis treatment, as it would worsen bone density.

C. Increase resorption of calcium: Increasing bone resorption would exacerbate osteoporosis by weakening the bones further.

D. Suppress calcitonin: Calcitonin helps to inhibit bone resorption, so suppressing it would be counterproductive in treating osteoporosis.

A. Tetany of the hands with a positive Chvostek sign B. Polyuria, sweating and dry mucous membranes C. Forgetfulness, depression and anemia D. Nervousness, irritability, and diarrhea

Correct Answer is C

Explanation

A. Tetany of the hands with a positive Chvostek sign: Tetany and a positive Chvostek sign are more associated with hypocalcemia rather than Hashimoto's thyroiditis.

B. Polyuria, sweating, and dry mucous membranes: These symptoms are more indicative of hyperthyroidism or diabetes rather than hypothyroidism, which is characteristic of Hashimoto's thyroiditis.

C. Forgetfulness, depression, and anemia: Hashimoto's thyroiditis, which causes hypothyroidism, can lead to symptoms like forgetfulness, depression, and anemia due to reduced thyroid hormone levels.

D. Nervousness, irritability, and diarrhea: These symptoms are associated with hyperthyroidism rather than hypothyroidism.

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A patient with diabetes mellitus (DM) developed a serum glucose of 900 and an elevated serum osmolality. The patient then became unconscious. What pathological process most likely caused the altered neurologic status?

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Correct Answer is A

Explanation

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Correct Answer is C

Explanation

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