A 19 year old female presents to the emergency department wi…

A 19 year old female presents to the emergency department with complaints from her best friend of “she isn’t acting her normal self”. The patient is lethargic though awakens to voice, tachypneic, diaphoretic, with poor skin turgor. Her best friend reports she hasn’t felt good for two days, but has progressively worsened. The patient denies any medical problems, smoking, or drug use. She reports she is not currently sexually active.  She complains of extreme thirst and fatigue.  Labs: WBC 20K, H&H 17.5 & 45, Plt 450K. Na+ 129, K+ 5.6, anion gap 25, Cr 1.8, BUN 40, Ca+ 8.5, glucose 448.  Vitals: Temp 97.8F, Pulse 122, BP 104/54, RR 34, O2 96% on room air.  Which diagnostic test is the most appropriate to order next? 

A 19 year old type I diabetic female has been in the intensi…

A 19 year old type I diabetic female has been in the intensive care unit for 2 days secondary to diabetic ketoacidosis (DKA). The insulin drip is infusing at 2units/hr. Suddenly the nurse notifies the AGACNP intensivist that the patient appears to be having a seizure. The seizure resolves after IV administration of a benzodiazepine. The nurse obtains a point of care glucose which results as 32.  What is the most appropriate treatment? 

During Exams, students must remove watches, ID Badges, cell…

During Exams, students must remove watches, ID Badges, cell phones, and anything in their pockets. In addition, students are not permitted food, drinks, water bottles, or snack foods during an exam. All belongings, papers, and the aforementioned items must be placed in a bag and left at the front of the room. Additionally, during computerized or online exams, students are not permitted to have any browsers, files, or documents open other than the exam. These procedures are also required when students are reviewing completed exams. Any attempt to print or save an exam is prohibited. It will be assumed a student is attempting to cheat if the student violates any of the aforementioned requirements. See the Medical Radiology Handbook