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NEW QUESTION: 1
A 55-year-old woman presented complaining of difficulty losing weight.
On examination, her blood pressure was 170/105 mmHg and urinalysis showed protein 1+.
An ultrasound scan of abdomen revealed a 4.5-cm solid lesion in the right adrenal gland. She was treated with ramipril and further endocrine evaluation was performed.
Investigations:
serum potassium3.6 mmol/L (3.5-4.9)
serum creatinine135 umol/L (60-110)
plasma renin activity:
(after 30 min supine)3.9 pmol/mL/h (1.1-2.7)
(after 30 min upright)6.8 pmol/mL/h (3.0-4.3)
plasma aldosterone:
(after 30 min supine)150 pmol/L (135-400)
(after 4 h upright)350 pmol/L (330-830)
serum cortisol (09.00 h)650 nmol/L (200-700)
serum cortisol (22.00 h)225 nmol/L (50-250)
24-h urinary free cortisol230 nmol (55-250)
24-h urinary dopamine3200 nmol (<3100)
24-h urinary adrenaline120 nmol (<144)
24-h urinary noradrenaline450 nmol (<570)
What is the most appropriate initial management of the adrenal lesion?
A. mineralocorticoid receptor blockade
B. ?-adrenoceptor blockade
C. medical observation with annual ultrasonography
D. angiotensin-2 receptor blockade
E. surgical excision
Answer: E

NEW QUESTION: 2
General HMO is building a provider network and is considering Universal Hospital as an addition to its network. Minimum requirements that General should consider in determining whether Universal is qualified to participate in General's network include A.
A. B only
B. Neither A nor B
C. Both A and B
D. A only
Answer: C

NEW QUESTION: 3
Refer to the exhibit.

The tunnel fails to come up. Which two actions resolve the issue? (Choose two)
A. On R1, change the tunnel destination to 10.1.3.2.
B. OnR1, change the IP address to 10.1.1.1.
C. On R2, change the IP address to 10.1.2.1
D. On R2, change the tunnel source to 10.1.2.1
E. On R1, change the tunnel source to 10.1.1.1
F. On R2, change the tunnel destination to 10.1.3.1.
Answer: A,B