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Her biologic mother abused multiple substances before and during pregnancy discount precose 50mg on line diabetes type 2 onset symptoms, and the patient was adopted shortly after birth cheap 25 mg precose fast delivery diabetes type 2 signs. The most likely explanation for these findings is in utero exposure to which of the following? A 77-year-old man comes to the physician with his daughter for a follow-up examination to learn the results of neuropsychological testing performed 1 week ago for evaluation of a recent memory loss order precose 50mg overnight delivery metabolic disease dogs. Results of the testing indicated cognitive changes consistent with early stages of dementia. Three weeks ago, he was diagnosed with prostate cancer and has shown signs of a depressed mood since then. Twenty years ago, he required treatment in a hospital for major depressive disorder. His symptoms resolved with antidepressant therapy, and he has not taken any psychotropic medication for the past 15 years. The patient’s daughter comes into the examination room before her father and asks that the physician not tell her father any information that might be upsetting, given his vulnerability to depression. She says she is concerned about what the results might be and how her father will handle them. Which of the following is the most appropriate initial physician statement to this patient? B - 122 - Surgery Systems Immune System 1%–5% Blood & Lymphoreticular System 5%–10% Nervous System & Special Senses 5%–10% Skin & Subcutaneous Tissue 1%–5% Musculoskeletal System 3%–7% Cardiovascular System 10%–15% Respiratory System 8%–12% Gastrointestinal System 20%–25% Renal & Urinary System 3%–7% Female Reproductive System & Breast 3%–7% Male Reproductive System 1%–5% Endocrine System 3%–7% Multisystem Processes & Disorders 5%–10% Social Sciences 1%–5% Medical ethics and jurisprudence Issues related to death and dying and palliative care Physician Task Applying Foundational Science Concepts 8%–12% Diagnosis: Knowledge Pertaining to History, Exam, Diagnostic Studies, & Patient Outcomes 50%–60% Pharmacotherapy, Intervention & Management 30%–35% Site of Care Ambulatory 35%–40% Emergency Department 25%–35% Inpatient 30%–35% Patient Age Birth to 17 8%–12% 18 to 65 60%–70% 66 and older 20%–25% - 123 - 1. A 52-year-old woman with glioblastoma multiforme in the frontal lobe tells her physician that she does not want operative treatment. She is mentally competent and understands that an operation is the only effective treatment of her tumor, and that without an operation she will die. She is afraid of the adverse effects of an operation and says she has lived a long and happy life. Two weeks later, she lapses into a coma, and her husband requests that the operation be carried out. Which of the following is the most appropriate consideration for her physician in deciding whether to operate? Ten years ago, a 60-year-old woman underwent an aortic valve replacement with a porcine heterograft. A 42-year-old woman comes to the emergency department because of a 2-day history of intermittent lower abdominal pain and nausea and vomiting. Initially, the vomitus was food that she had recently eaten, but it is now bilious; there has been no blood in the vomit. Examination shows a distended tympanitic abdomen with diffuse tenderness and no rebound. A 4-year-old boy is brought to the physician by his parents because of a 4-month history of difficulty running and frequent falls. His parents report that his calves have been gradually increasing in size during this period. An 18-year-old man is brought to the emergency department 10 minutes after he sustained a stab wound to his chest.

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An abrupt cheap 25 mg precose diabetes in dogs sores, sustained increase in perfusion pressure increases flow initially buy generic precose 25 mg diabetes symptoms dogs, but over the course of 1 minute precose 50 mg fast delivery diabetes diet nigeria, the flow returns nearly to the baseline level despite continued elevation of the perfusion pressure. After an overnight fast, a 52-year-old man undergoes infusion of acid through a catheter into the upper duodenum. This most likely will increase pancreatic secretion mainly through the action of which of the following substances? A 20-year-old woman is brought to the emergency department 20 minutes after being stung by a wasp. A demonstration is performed during a lecture on muscle physiology in which a student is asked to fully extend his right arm with the palm up. Which of the following facilitates the maximum amount of tension that allows the student to keep his arm extended in place under the increasing weight of the books? During an experiment on the cough reflex in humans, a volunteer inhales air containing different amounts of particles that will impact and adhere to mucus primarily in the trachea. Blockade of which of the following receptors would most likely prevent this volunteer’s reflex to initiate a cough? A female newborn delivered at 32 weeks’ gestation develops severe respiratory distress within hours of birth. Examination of the lungs at autopsy shows lung alveoli with radii of less than 50 μm (N=100). A 55-year-old woman who is obese has a greater risk for endometrial carcinoma than a 55-year-old woman with the same health history and status who is not obese. A 4-hour-old female newborn delivered at 30 weeks’ gestation has respiratory distress. The primary cause of this patient’s condition is a dysfunction of which of the following cell types? A 22-year-old man is brought to the emergency department because of a 6-hour history of severe, sharp, upper back pain. Which of the following best describes the primary genetic cause of this patient’s condition? A 25-year-old woman comes to the physician because of a 2-day history of muscle cramps and profuse, watery stools. Stool culture shows numerous curved, gram-negative bacteria; there are no erythrocytes or leukocytes. The oral hydration formula most likely promotes sodium absorption via the gut by allowing cotransport with which of the following? A 26-year-old woman is brought to the emergency department because of a 4-day history of flu-like symptoms accompanied by vomiting following each attempt to eat or drink. A 77-year-old man comes to the physician because of swelling of his legs and feet for 6 months. A decrease in which of the following most likely promotes edema formation in this patient? During a study of gastric parietal cells, an investigator attempts to elicit maximum hydrochloric acid secretion from the stomach of an experimental animal. Which of the following combinations of substances is most likely to lead to this desired effect? Acetylcholine Gastrin Histamine Secretin (A) Increased increased increased increased (B) Increased increased increased decreased (C) Increased decreased decreased increased (D) Decreased increased increased increased (E) Decreased decreased increased increased (F) Decreased decreased decreased decreased (G) Decreased decreased decreased decreased - 66 - 19. A 30-year-old woman comes to the physician for a routine health maintenance examination. An increase in which of the following substances is the most likely cause of the serum finding in this patient? A 28-year-old woman comes to the physician because of a 3-month history of shortness of breath with exertion.

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