Correct Answer: A

Rationale: Lispro (Humalog) is a rapid-acting insulin analog designed for mealtime glucose control. It begins action within 15 minutes, peaks in 1 hour, and lasts 2 to 4 hours. Its quick onset matches postprandial glucose spikes, enhancing glycemic control during meals and preventing hyperglycemia from carbohydrate intake. Glargine (Lantus) is a long-acting basal insulin with no peak and prolonged action. It does not target mealtime spikes but provides steady glucose control over 24 hours. Its slow onset and constant release profile are unsuitable for immediate postprandial glucose management. Detemir (Levemir) is a long-acting basal insulin, similar to glargine, with extended action for baseline glucose control. It lacks the rapid onset needed for mealtime management, making it inappropriate for postprandial hyperglycemia control, as observed in Lispro efficacy. NPH (Humulin N) is an intermediate-acting insulin with delayed onset and peak activity. It supports baseline glucose regulation but fails to address mealtime glucose control promptly. Its time profile does not align with the immediate needs of postprandial hyperglycemia management.

Correct Answer: B

Rationale: Endoscopy is a diagnostic procedure used for evaluating persistent or severe symptoms of heartburn, but it is not part of initial treatment. Patient education focuses on symptom relief and management strategies before invasive testing. Proton pump inhibitors reduce gastric acid secretion by irreversibly blocking H+/K+ ATPase in stomach parietal cells. They are first-line medications for heartburn and gastroesophageal reflux disease, effectively relieving symptoms and preventing complications. Radionuclide tests are specialized diagnostic procedures for conditions such as gastric emptying disorders. They are not standard educational topics for new heartburn complaints, as they do not provide immediate symptom relief. A barium swallow is used for imaging structural abnormalities of the esophagus or stomach but is not part of initial management for heartburn. It is a diagnostic tool rather than a first-line treatment or educational focus.

Correct Answer: A

Rationale: X-rays are commonly used to diagnose osteoarthritis as they effectively visualize joint space narrowing, osteophyte formation, and subchondral sclerosis, which are characteristic of OA. These imaging findings assist in confirming the diagnosis and assessing disease progression. Lithography is not a diagnostic tool used for OA. It primarily refers to a printing method and has no relevance to imaging joints affected by osteoarthritis or diagnosing the condition scientifically. Ultrasound can visualize soft tissues but is not routinely used for OA diagnosis. It does not provide the detailed assessment of joint degeneration seen in X-rays, making it less appropriate for identifying OA-related changes. Echocardiograms are used to assess heart function and have no application in diagnosing osteoarthritis. They are irrelevant in imaging joint structures or evaluating degenerative joint diseases scientifically.

Correct Answer: A:D,B:B,C:E,D:A,E:C

Rationale: Osteomalacia matches choice D: It is caused by a vitamin D deficiency, leading to reduced calcium absorption, softening bones, and increasing fracture risk, uncommon in developed countries due to dietary fortification. Low back pain matches choice B: It is commonly due to musculoskeletal issues like muscle strain or disc problems and can present as localized or diffuse pain. Osteomyelitis matches choice E: It is a severe bacterial infection affecting bone and surrounding tissues, often requiring prolonged antibiotic therapy. Osteoporosis matches choice A: It is a chronic condition characterized by low bone mass and structural deterioration, increasing fragility and fracture risk, especially in postmenopausal women. Degenerative disc disease (DD
D) matches choice C: It involves age-related loss of disc fluid, reducing elasticity and shock absorption, contributing to back pain and spinal issues.

Correct Answer: C

Rationale: Removing the external fixator for a shower could compromise stabilization of the fracture. External fixators are designed to be left in place to maintain proper alignment and provide structural support for healing bones. Removing the device could introduce unnecessary risks, including increased mobility and potential damage to the fracture site. Prolonged bed rest is not indicated for patients with external fixation devices unless medically necessary. Prolonged immobility can lead to complications such as deep vein thrombosis, muscle atrophy, or joint stiffness. Mobilization should be encouraged as tolerated to support recovery. Proper cleaning of pin insertion sites prevents infection, a major risk with external fixation devices. Using sterile technique to clean the sites daily reduces bacterial colonization. Monitoring for signs of infection such as redness or drainage is critical to avoid osteomyelitis or systemic spread. Prophylactic antibiotics are typically administered perioperatively but are not continued until device removal unless there are specific complications. Prolonged antibiotic use can lead to antimicrobial resistance and should only be used as clinically indicated to prevent or treat infection.