Correct Answer: C

Rationale: Incisions into the renal pelvis for stone removal describe open surgical methods, not ultrasonic lithotripsy. This invasive approach is reserved for cases where less invasive techniques fail or stones are inaccessible through standard methods. Lithotripsy avoids direct incisions, utilizing external energy for stone fragmentation. Kidney incisions for stone removal align with nephrolithotomy procedures rather than ultrasonic lithotripsy. This alternative represents open surgical intervention, distinct from non-invasive lithotripsy technologies. Lithotripsy eliminates stones using sound waves or lasers, reducing surgical risks and recovery times. Ultrasonic lithotripsy employs high-frequency sound waves to break stones into small fragments. This minimally invasive method allows natural passage through the urinary tract or facilitates removal via catheterization. It reduces complications compared to invasive surgeries and is highly effective for calculi management. Laser fragmentation techniques differ from ultrasonic lithotripsy, involving concentrated light energy to break stones. While both are minimally invasive, ultrasonic methods utilize sound waves rather than light energy for disintegration. This technical distinction outlines lithotripsy's use of external sound waves for stone management.

Correct Answer: F

Rationale: Dextrose IVP is unnecessary with hyperglycemia. It increases the glucose level further, risking complications like hyperosmolar hyperglycemic state. This treatment is reserved for severe hypoglycemia. Glucagon raises blood glucose and is contraindicated for hyperglycemia. It is used to treat hypoglycemia, not elevated glucose levels seen here. Holding insulin neglects hyperglycemia management, allowing complications like ketoacidosis or delayed glucose control. Insulin is necessary to address elevated blood sugar. Calling the MD delays hyperglycemia treatment unnecessarily, as nurses can administer insulin per protocols in cases like this. Administering 15 units of Humalog risks inducing hypoglycemia. It is an excessive dose given the glucose level of 243 mg/dL. Administering 4 units of Humalog is an appropriate corrective dose for a pre-meal glucose of 243 mg/dL. Rapid-acting insulin efficiently reduces glucose to safer levels, aligning with treatment protocols. Administering 9 units of Humalog risks overcorrecting hyperglycemia, potentially causing hypoglycemia, as it exceeds typical sliding scale guidelines for this glucose level. Administering 5 units of Humalog could be reasonable for slight hyperglycemia, but it is not specifically aligned with the sliding scale dose appropriate for 243 mg/dL.

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: D

Rationale: Lispro (Humalog) is a rapid-acting insulin used for mealtime glucose control. It has an onset of 15 minutes and peaks within 30 minutes to 1 hour, making it unsuitable for basal dosing. Aspart (NovoLog), another rapid-acting insulin, is similar to lispro in its onset and peak times. It is also used for mealtime glucose control, not basal glucose regulation. Regular insulin (Humulin R) is a short-acting insulin with an onset of 30 minutes to 1 hour and a peak of 2 to 4 hours. It cannot provide the steady basal glucose control required for 24-hour coverage. Glargine (Lantus) is a long-acting insulin that provides consistent basal glucose control with no pronounced peak. It is designed for once-daily dosing to maintain stable glucose levels over 24 hours, meeting the requirements for basal dosing.

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.