مـادة إضـافيـة🧭

🌸 The cause of pulmonary embolism in the following case is ? 💫 Deep venous thrombosis 🌸 Which therapy should be indicated acutely for the patient? 💫 Low molecular weight heparin or unfractionated heparin followed by warfarin 🌸 What are long term therapy options for the patient? 💫 Parenteral anticoagulant for 5-7 days followed by rivaroxaban or apixaban 🌸How long should she treated ? 💫 3-6 months 🌸 Oral contraceptive should be stopped and replaced by other contraceptive option? 💫 True

🌸factors worsening patient condition making it is difficult to achieve glycemic goal Despite administration of 125 unite of insuline daily in this case are 💫 Hypertension 💫 obesity 💫 Heavy smoking 💫low HDL 🌸 Before antiglycemic drugs , patient need to ••••••••• to achieve glycemic goal 💫 Stop smoking 💫 control hypertension 💫lose of weight 🌸 according to antiglycemic drugs, you will prescribe your patient to : 💫 re initiate Metformin 💫 Add GLP 1 analogue ( exentaide) 💫 Reduce daily insulin dose 🌸 For management of diabetes in this obese patient : antiglycemic drug of choice in this patient is : 💫 Exentaide ( GLP 1 analogue) 🌸 If patient lose weight, and want to stop insulin: To achieve Tight glycemic control in this patient which combination of antiglycemic agents are indicated: 💫 Metformin 💫 exentaide 💫glimipride 🌸 which of the following oral antiglycemic agents should be added for diabetic nephropathy 💫 SGLT2 Which of the following oral antiglycemic drug should be used carefully ( with small dose ) in this patient to avoid more increase in body weight? 💫 Glimipride ( sulfonylureas)

🌸what is the cause of megaloblastic anemia in the case? 💫 Dietary Vitamin B12 deficiency 🌸 What is the cause of Deficiency of vitamin B12 in the case ? 💫 Dietary : the patient is vegetarian 🌸 Why folate concentration is measured in this case? 💫 To exclude folate deficiency( another cause of megaloblastic anemia) 🌸 Patient need supplementation of vit B12 : 1/ parentally 2/ orally 3/ both ✅ 🌸 Parenteral administration of vitamin B12 is for : 💫 Rapid correction for neurological symptoms 🌸 Oral vitamin B12 supplements in this patient may be indicated to: 💫 Restore and maintain body stores 🌸 What will happen if patient condition is mistaken for folate deficiency and folate administration starts? 💫 Megaloblastic anemia will be corrected but neurological symptoms will be worsen 🌸 All patient neurological symptoms in the case will be improved after vitamin B12 supplements? ✅ True 🌸 If the condition not treated, neurological symptoms will be irreversible? ✅ True