Problem 1. Compare and contrast type 1 and type 2 diabetes mellitus. How are these diseases similar (e.g., blood glucose levels)? How do these diseases di?er from one another?
Problem 2. Enalapril is a medication used to treat high blood pressure, diabetic kidney disease, and heart failure. It vasodilates the blood vessels leading out of the kidney (i.e., more blood flows out and decreases blood pressure in the kidney).
Aspirin, ibuprofen, and naproxen are nonsteroidal anti-inflammatory drugs (NSAIDs). In addition to relieving pain, these medications constrict the blood vessels leading into the kidneys. What effects might the combination of these medications have on the kidney?
Problem 3. Metformin is the first-line medication to treat type 2 diabetes mellitus. It works by inhibiting gluconeogenesis in the liver and increasing insulin sensitivity. Why would this help treat type 2 diabetes mellitus?
Problem 4. Metformin increases lactate production in the small intestines and decreases the liver's ability to convert lactate into pyruvate. The kidneys normally clear metformin, lactate, and excessive H+ from the blood. What do MC's lab values indicate about her kidney function? Could this help explain her acidosis?
Problem 5. Why was MC's respiratory rate elevated (45 breaths/min)? Is this related to the low level of bicarbonate in her blood?