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furthermore, FA 2019 pg 47
You're a good man.
I think the distribution half-life and elimination half-life was saying that by the time you checked, it had fully distributed (10 half-lifes) and had not been cleared yet (super long half-life)
1000ug= 1mg and 1g=1000000ug
so then 4ug/ml * 1g/ 1000000ug= 0.000004 g/ml
0.000004g/ml * 1000ml/L= 0.004 g/L
80mg*1g/1000mg= 0.08 g
vd= 0.08g/ 0.04g/l =20L
Or, like a normal human, convert 4ug/mL into mg/L ... which is 4 mg/L. 80mg/4mg/L is 20L.
Hope your day got a little better after this
I think the reason dietician was incorrect is because she has had diabetes for 6 years and her diabetes was well controlled that entire time. Then for the past two months her glucose control has been poor. This is pointing towards the issue NOT being that they don't know how to manage the diabetes so referring to a dietician wouldn't be useful.
99.99/100 times the answer will never include referral. The only reason I do not say 100/100 is because there may be an answer one day that is to refer, but through all of UW, Rx, and NBME it has never been to refer, so do with that info what you will
I would also take into account that this patient has had HTN and T2DM for 20 years. His kidneys are probably shot.
I got this wrong too, but I think the exercise of internal rotation makes sense because it will isolate the muscle (without assistance by teres minor for adduction).
The subscapularis assists in medial (internal) rotation and adduction, but the teres minor also assists in adduction, so the best choice to isolate the subscapularis would be internal (medial) rotation. Choice E
@tiredofstudying teres major also internally rotates so it wouldn't really be isolated either.
I guess Tmajor isn't relevant cuz it's not a SITS muscle? Still a stupid question.