A48-year-old woman with a history of type 1 diabetes mellitus and hyperlipidemia has had gradually progressive numbness, tingling, and gait difficulties for the past 12 months. she first noticed numbness and tingling in her hands, followed by thigh stiffness, numbness in the feet and calves, and most recently gait instability. she has no history of neurologic symptoms. examination reveals no electrical sensation radiating down her spine with neck flexion, as well as normal mental status and cranial nerve function, including funduscopic examination. manual muscle testing demonstrates normal extremity power, bulk, and tone, but slight proximal lower extremity weakness with minimally increased tone in her feet. there are bilateral hoffmann signs, sustained clonus of the right ankle, and three beats of clonus on the left, with extensor plantar responses bilaterally. she has no joint proprioception in the ankles and toes, with mildly reduced touch and severely reduced vibration; she also has moderately reduced vibration in her fingers. her gait is ataxic and spastic with a positive romberg sign. an mri scan of the brain is unremarkable. what laboratory results would confirm the diagnosis?

The presence of aids in a community often increases its level of property what is one of the main reasons for this

The parents of a 9-year-old girl bring their daughter to the ed. for the last 12 hours, the child has suffered severe nausea and vomiting, as well as diarrhoea and abdominal cramps. further discussion with the child indicates that she suffers from blurred vision and headache. the parents originally were worried about bringing the child to the ed because they feared deportation since the family are illegal immigrants employed to pick strawberries on a nearby farm. on direct questionning, the parents admit that the child was assisting with spraying crops with pesticides the previous day. none of the family members was wearing any protecting clothing. her bp is 88/48 mmhg, pulse is 90/min, rr 33/min, temp 38 c. the child appears sweaty and confused. auscultation of the lungs reveals a diffuse wheeze bilaterally. pupils are miotic and the child has diffuse muscle weakness. which of the following interventions is the most appropriate treatment? - atropine- charcoal- glucagon- naloxone- exposure: consider organophosphate poisoning, which inhibits cholinesterase and results in accumulation of ach in both muscarinic and nicotinic sites. pralidoxime activates achatropine competes with ach only at muscarinic receptors, but will not reverse nicotinic effectscharcoal = gastric decontaminationglucagon = reverse beta-blocker overdosenaloxone = reverse effects of opioids

If a doctor needs using a medical imaging machine, a might be called to assist the doctor.