frontal
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A 50-year-old female is 5 ft 7 in. tall and weighs 165 lb. There is a family history of diabetes mellitus. Fasting blood glucose is 150 mg/dL on two occasions. She is asymptomatic, and physical exam shows no abnormalities. The treatment of choice is
A)
Observation
B) Medical nutrition therapy
C) Insulin
D) Oral hypoglycemic agent
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| ARJ
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B) Medical nutrition therapy
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| Dot
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Agree with ARJ
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| chemamr
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B
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| drkpp
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B
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| Renegade
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Sorry for going beyond the question, but I can't help to wonder if she was pregnant before and what happened during pregnancy. If she had diabetes, maybe I'd go for D. Her risk would be a lot higher then.
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| alenka
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i agree-but remeber what they say-if it's not mentioned in the question-assume that it's not present.if she was pregnant-they would have said about it.
and one more question-what does this medical nutrition therapy consist of?
thanks
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| drkpp
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oral hypoglycemics contraindicated in pregnancy
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| ARJ
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I think Medical is acarbose and nutrition is Diet modifications. drkpp is right.
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| frontal
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Well done people. The answer is B. It is true that those who develop gestational diabetes are at a higher risk for developing diabetes later. But this case has already developed diabetes so this history is of no predictive value. And yes, if we must assume, the assumption should be that she is not pregnant  so if oral hypoglycemics are contraindiacated in pregnancy, they are not contraindicated in our case. Here is the explanation provided for the answer along with a description:
The answer is b. The classification of diabetes mellitus has changed to emphasize the process that leads to hyperglycemia. Type 2 DM is a group of heterogeneous disorders characterized by insulin resistance, impaired secretion of insulin, and increased glucose production. Medical nutrition therapy is a term now used to describe the best possible coordination of calorie intake, weight loss, and exercise. It emphasizes modification of risk factors for hypertension and hyperlipidemia, not just weight loss and calorie restriction. In this type 2 patient, medical nutrition therapy that includes dietary modification, weight loss, and exercise is the first intervention. Blood glucose control should be reevaluated after 3 to 4 weeks. If target blood sugar is not met, pharmacotherapy should be initiated.
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| alenka
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well done,frontal.
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| Dot
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great Frontal.U r reading harrison too much.
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| frontal
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Umm, not too much Dot. Soon, I hope to get the right books. I'm moving at such a slow pace, it's scaring the hell outta me.
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