Block 5 DPS Ime & Pancreas MCQ's

Glucagon increases the availability of glucose, which is the most likely explanation for its ability to stimulate insulin release. When glucagon is released, it signals the liver to break down glycogen into glucose, increasing the amount of glucose available in the bloodstream. This increase in glucose levels then triggers the release of insulin, which helps to lower blood sugar levels. Therefore, by increasing the availability of glucose, glucagon indirectly stimulates insulin release.

A 48-year-old man with type 1 diabetes who is started on intensive therapy with insulin to achieve tight control of his blood glucose levels is at an increased risk of hypoglycemia. Intensive insulin therapy aims to maintain blood glucose levels within a narrow range, which can increase the risk of hypoglycemia, or low blood sugar. This is because insulin helps to lower blood glucose levels, and if too much insulin is administered or if the timing of insulin and meals is not properly coordinated, it can result in hypoglycemia. Hypoglycemia can cause symptoms such as dizziness, confusion, sweating, and in severe cases, loss of consciousness. It is important for individuals on intensive insulin therapy to monitor their blood glucose levels closely and take necessary precautions to prevent hypoglycemia.

Exercise is an evidence-based therapy that would be appropriate to prescribe to the patient. Regular exercise has been shown to have numerous health benefits, including weight loss, improved cardiovascular health, and reduced risk of chronic diseases such as diabetes and certain types of cancer. By engaging in exercise 4 times a week, the patient can increase their physical activity level, burn calories, and potentially achieve their goal of reducing their BMI to a healthier range.

The synthesis of insulin requires the formation of disulfide bonds. Disulfide bonds play a crucial role in stabilizing the structure of insulin, a hormone produced by the pancreas. These bonds are formed between two cysteine amino acids, where the sulfur atoms from each cysteine form a covalent bond. This process is essential for the proper folding and function of insulin, allowing it to regulate blood sugar levels in the body. Without the formation of disulfide bonds, insulin would not be able to maintain its structure and function effectively.

Lumbar puncture can be considered an iatrogenic cause for a spinal cord injury because it involves the insertion of a needle into the spinal canal, which can potentially damage the spinal cord if not performed correctly. While neurosyphilis, meningitis, motor vehicle accidents, and osteoporosis can all lead to spinal cord injuries, they are not considered iatrogenic causes as they are not directly caused by medical intervention or treatment.

Insulin stimulates glycogen synthase and phosphofructokinase-1, which are enzymes involved in the regulation of glucose metabolism. Glycogen synthase promotes the conversion of glucose into glycogen for storage, while phosphofructokinase-1 stimulates the breakdown of glucose to produce energy. By activating these enzymes, insulin helps to lower blood glucose levels by promoting the storage and utilization of glucose.

In patients with established neurosyphilis and damage to the spinal cord, a high stepping gait may be observed. This gait abnormality is characterized by exaggerated lifting of the legs, resulting in a higher than normal stepping motion. It is often seen in patients with spasticity or weakness in the lower extremities due to spinal cord involvement. The high stepping gait is a compensatory mechanism to overcome the impaired muscle function and maintain balance while walking.

Acinar cells of the pancreas are responsible for producing and secreting proteases. Proteases are enzymes that help in the digestion of proteins. These enzymes are important for breaking down proteins into smaller peptides and amino acids, which can be absorbed by the body. Therefore, the characteristic of acinar cells producing and secreting proteases is essential for proper digestion and nutrient absorption in the body.

In Type I diabetes mellitus, the body is unable to produce insulin. Therefore, when the patient ingests dextrose during the OGTT, there will be a strong, long surge in plasma glucose from a high baseline because there is no insulin to help regulate the glucose levels. Additionally, there will be very little surge in plasma insulin because the patient is not producing insulin.

The correct answer is "About 12,000 new cases per year". This answer is supported by the information provided in the question, which states that there are approximately 12,000 new cases of spinal cord injuries per year. The other options mentioned in the question, such as the incidence being 10% of the population or the number of cases at any point in time being 250,000, are not supported by the given information. Additionally, the question does not provide any information about the prevalence of spinal cord injuries among young males or their cause being mostly motor vehicle accidents.

The patient's symptoms of loose stools and excessive flatulence may be related to stress and anxiety, as she appears tense and anxious. The fact that her symptoms started after returning from a visit to her family and gaining weight while studying for exams suggests a possible emotional component to her symptoms. Encouraging the patient to enroll in a mindfulness meditation class can help her manage her stress and anxiety, which may in turn alleviate her gastrointestinal symptoms. This approach addresses the underlying cause of her symptoms rather than simply treating the symptoms themselves.

Insulin is the correct answer because during the absorptive state, insulin is released by the pancreas in response to high levels of glucose in the blood. Insulin promotes the uptake of glucose by muscle cells, thereby preventing excessive glucose levels in the plasma. Additionally, insulin stimulates the synthesis of proteins, including muscle tissue, promoting growth.

Insulin aspart is a rapid-acting insulin analog that is commonly used to control postprandial hyperglycemia in patients with type-1 diabetes mellitus. It has a fast onset of action, typically within 15 minutes, and a shorter duration of action compared to other types of insulin. This allows for better control of blood sugar levels after meals. Insulin ultralente, insulin glargine, and insulin NPH are not typically used before meals as they have slower onsets of action and longer durations of action.

The most appropriate statement for the physician to make is "What ideas do you have about the relationship between your tobacco use and other things going on in your life." This statement encourages the patient to reflect on the connection between his tobacco use and his headaches, as well as other factors in his life. It allows the patient to explore his own thoughts and beliefs about the situation, which can help in understanding the underlying reasons for his tobacco use. This approach promotes patient-centered care and empowers the patient to take an active role in his own healthcare decisions.

Based on the information provided, the patient has a BMI of 25.9, which falls within the overweight range. Additionally, his waist circumference is 42 inches, which indicates abdominal obesity. These factors suggest that the patient is at a higher risk for developing obesity-related diseases such as diabetes, heart disease, and certain types of cancer. Therefore, the correct answer is "High" as the patient's risk for developing an obesity-related disease is elevated.

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Glyburide is an antidiabetic drug that can cause hypoglycemia when used as monotherapy in a patient with type 2 diabetes. This is because Glyburide stimulates the release of insulin from the pancreas, which can lead to a decrease in blood sugar levels. Hypoglycemia occurs when blood sugar levels drop too low, causing symptoms such as dizziness, confusion, and sweating. Therefore, Glyburide should be used with caution and the patient should be closely monitored for signs of hypoglycemia.