An elderly patient is hospitalized with several problems. His medical history includes uncontrolled hypertension and Type II diabetes mellitus (DM). A HbA1c is measured This laboratory test measures the

percentage of glycosylated hemoglobin molecules that spill into the urine.

percentage of glycosylated hemoglobin molecules carried by RBCs.

effect of hypertension on RBCs over a long period of time.

effect of insulin on the ability of hemoglobin to bond with glucose.

Answer and Explanation

The Correct Answer is B

A. His body does not produce any insulin so he must receive insulin injections: Type I diabetes is characterized by the destruction of pancreatic beta cells, resulting in little to no insulin production. Therefore, insulin must be administered via injection to replace the insulin the body cannot produce.

B. The pills are not as effective as the insulin injections: While this might be partially true for Type I diabetes, it is not the complete answer. Oral medications are generally not effective in Type I diabetes because they stimulate the pancreas to produce insulin, which is not possible in these patients.

C. He will only be on insulin injections for a short while, then he can take a pill: This is incorrect. Type I diabetes requires lifelong insulin therapy.

D. He can stop the insulin injections once his body begins to make insulin again: This is incorrect as Type I diabetes is a permanent condition where the body cannot produce insulin.

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Correct Answer is D

Explanation

A. Vertigo and bilateral loss of the pupillary light reflex: Vertigo can occur with cerebellar involvement, but loss of the pupillary light reflex is more associated with brainstem damage.

B. Nuchal rigidity and positive Kernig's sign: These are signs of meningitis, not a cerebellar stroke.

C. Report of falling down, nausea, and vomiting: These symptoms can occur with cerebellar strokes, but they are nonspecific and can be seen in other conditions as well.

D. Difficulty speaking and loss of coordination: The cerebellum is responsible for coordination, and a cerebellar stroke can lead to ataxia (loss of coordination) and dysarthria (difficulty speaking).

A. status epilepticus. B. anticonvulsant syndrome. C. syphilitic posturing. D. positive Babinski reflex

Correct Answer is A

Explanation

A. Status epilepticus: Status epilepticus is a life-threatening condition where seizure activity is continuous or occurs in rapid succession without recovery between seizures.

B. Anticonvulsant syndrome: This term is not a recognized medical condition.

C. Syphilitic posturing: This term is not associated with seizure disorders and is not a recognized condition.

D. Positive Babinski reflex: This indicates an upper motor neuron lesion but is not related to continuous seizure activity.

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