A 48‐year‐old man, recently diagnosed with type 2 diabetes mellitus, comes to his primary care physician’s office for follow‐up. He is advised on a regimen of diet and exercise with frequent monitoring of his fasting and 2‐hour postprandial blood sugars. His blood pressure is checked on several separate occasions, and he is started on an ACE inhibitor that affords good blood pressure control. A physical examination at this visit is within normal limits. A fasting lipid profile, 12‐lead electrocardiogram (ECG), blood urea, and creatinine are all within normal limits. Urinalysis including microalbumin is also within normal limits. Which of the following screening tests should be recommended in this patient, given the recent diagnosis of diabetes?
- A. 2D echocardiogram
- B. Colonoscopy
- C. Eye examination yearly
- D. PSA yearly
- E. Upper gastrointestinal endoscopy
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A 52‐year‐old man presents to the emergency department vomiting blood. He is a known alcoholic and admits to a recent alcohol binge. His heart rate is 140/min, blood pressure is 70/40 mm Hg, and temperature is 37.2 C (98.9 F). Initial laboratory tests reveal a hemoglobin level of 7 g/dL and a hematocrit value of 21. He is given 3 units of packed red blood cells and undergoes upper gastrointestinal endoscopy that reveals diffuse gastritis. The patient is then begun on an intravenous H2‐receptor blocker. Twenty‐four hours after admission, he develops confusion and tremors and becomes combative, even attempting to strike a nurse. He is seen talking alone in the room. Which of the following is the most appropriate next step in the management of this patient?
- A. Administer intravenous chlorpromazine
- B. Administer intravenous diazepam
- C. Administer intravenous haloperidol
- D. No medications are needed at this time
- E. Use of physical restraints
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