Case Studies Answers

CASE

STUDIES

A N S W E R S

CASE

ONE

Answer

HM has multiple risk factors fordiabetes. Her risk factors include the following: age >45 years, body massindex >25 kg/m2, family

history of diabetes,African-American race, hypertension, and dyslipidemia (particularly if herhigh-density lipoprotein cholesterol

is <35 mg/dL or her triglyceridelevel is >250 mg/dL).

CASE

TWO

Answer

When mixing regular (or otherrapid-acting) insulin with NPH (or other longer-acting) insulin, the clearregular insulin should be

drawn into the syringe before thecloudy NPH insulin.

CASE

THREE

Answer

Unfortunately, DR cannot believe thepharmacist. First, the pharmacist exhibits the classic symptoms of opiate use,including pinpoint

pupils, drowsiness, and itching.Second, the amount of codeine and morphine found in poppy-seed bagels is notenough to

cause symptoms of intoxication.Third, morphine typically predominates over codeine when poppy seeds areingested. The pharmacist's

drug screen shows a predominance ofcodeine, as would be seen after codeine ingestion.