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  #1  
Old 09-30-2014
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USA Last Question of the month

A 53 year old patient complains of decreased vision. His serum glucose level is 130 gm/dl. After a thorough evaluation he is prescribed with a diuretic and the symptoms resolve completely. What can be additionally prescribed to avoid complications.

a. Vitamin B12
b. Folic acid
c. Thiamine
d. Vitamin C
e. Iron tablets
f. Exposure to sunlight
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  #2  
Old 09-30-2014
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Quote:
Originally Posted by Panmedic View Post
A 53 year old patient complains of decreased vision. His serum glucose level is 130 gm/dl. After a thorough evaluation he is prescribed with a diuretic and the symptoms resolve completely. What can be additionally prescribed to avoid complications.

a. Vitamin B12
b. Folic acid
c. Thiamine
d. Vitamin C
e. Iron tablets
f. Exposure to sunlight
F? --> increased Vit D
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  #3  
Old 09-30-2014
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Quote:
Originally Posted by Panmedic View Post
A 53 year old patient complains of decreased vision. His serum glucose level is 130 gm/dl. After a thorough evaluation he is prescribed with a diuretic and the symptoms resolve completely. What can be additionally prescribed to avoid complications.

a. Vitamin B12
b. Folic acid
c. Thiamine
d. Vitamin C
e. Iron tablets
f. Exposure to sunlight
Hmm am thinking the pt is having open angle glaucoma & they prescribed CAI
am confused what to choose from the answers provided...
Ill go for a. vitb12
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  #4  
Old 09-30-2014
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damn i have no idea.

is it acetozolamide?

and b12 to avoid neuropathy?
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  #5  
Old 09-30-2014
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Yes indeed it's the last question of the month!
__________________
In USMLE, ďAny fool can know. The point is to understand.Ē
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  #6  
Old 09-30-2014
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I will go with Vit B12
To avoid complication of diabetes
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  #7  
Old 09-30-2014
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Come on guys give your explanations. Vitamins are good but here we can prevent a serious problem by prescribing the right one!
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  #8  
Old 09-30-2014
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Vitamine C. Antioxydant? I would have choose vitamin A but it is not available...
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  #9  
Old 09-30-2014
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Default The Answer

Yes the answer is vitamin C. But long-term diuretic use can lead to depletion of Thiamine and B6 too. Other minerals are also depleted depending on the type of the diuretic used.
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  #10  
Old 09-30-2014
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er i didnt understand. Why is Vit C the correct answer?

What did the pt originally have?

Why does the anti oxidant help?
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  #11  
Old 09-30-2014
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I think its Vitamin C because out of all the options it is the one which is prone to being lost in urine the most, as it is water soluble and not stored in the body. B12 and folate are water soluble too, but are stored.
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  #12  
Old 09-30-2014
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Pandemic can u plz xplain the reason well..
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  #13  
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Quote:
Originally Posted by Panmedic View Post
A 53 year old patient complains of decreased vision. His serum glucose level is 130 gm/dl. After a thorough evaluation he is prescribed with a diuretic and the symptoms resolve completely. What can be additionally prescribed to avoid complications.

a. Vitamin B12
b. Folic acid
c. Thiamine
d. Vitamin C
e. Iron tablets
f. Exposure to sunlight
can you please explain the answer and the source of the question.
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  #14  
Old 10-01-2014
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This patient has glaucoma, he is prescribed diuretics to counter the disease.
Diuretics deplete many elements and vitamins from the body.
Out of those we have depleted
Vitamin C
and
Thiamine

I made this Question after looking into a MCQ book.
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  #15  
Old 10-01-2014
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I thougt like this
On using acetazolamide one f the complitions is urinary caliculi formation due to alkalisation of urine.
To prevent this ascorbic acid vitÁ can b given.
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  #16  
Old 12-03-2014
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The answer is c. Thiamine, the patient most likely have a dx of Open angle glaucoma and is been treated with acetazolamide, which is know to cause thiamine depletion. Urinary thiamine loss is caused by a nonspecific, flow-dependent mechanism common to all of the diuretics. Regarding the use of vitamin C (actually ascorbic acid) as a prophylaxis for kidney stones formation, this is not a common practice, and usually the pt is prescribed to drink cranberry juice or betaine, which can lower the urine pH, ascorbic acid in order to do this, need high doses that predispose the formation of calcium oxalate kidney stones.
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  #17  
Old 12-03-2014
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Best explained, that's correct anagoras
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  #18  
Old 12-03-2014
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I believe its thiamine vitamin B9
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  #19  
Old 12-03-2014
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Default Answer

I think Thiamine due to the depletion with diuretic and hyperglycemia



QUOTE=Panmedic;506049]A 53 year old patient complains of decreased vision. His serum glucose level is 130 gm/dl. After a thorough evaluation he is prescribed with a diuretic and the symptoms resolve completely. What can be additionally prescribed to avoid complications.

a. Vitamin B12
b. Folic acid
c. Thiamine
d. Vitamin C
e. Iron tablets
f. Exposure to sunlight[/QUOTE]
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  #20  
Old 12-05-2014
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Quote:
Originally Posted by Laurentiu View Post
I think Thiamine due to the depletion with diuretic and hyperglycemia



QUOTE=Panmedic;506049]A 53 year old patient complains of decreased vision. His serum glucose level is 130 gm/dl. After a thorough evaluation he is prescribed with a diuretic and the symptoms resolve completely. What can be additionally prescribed to avoid complications.

a. Vitamin B12
b. Folic acid
c. Thiamine
d. Vitamin C
e. Iron tablets
f. Exposure to sunlight
[/QUOTE]
f
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