A patient has recently been diagnosed with multiple sclerosis. Which response best explains the etiology of multiple sclerosis (MS)?

A. His body does not produce any insulin so he must receive insulin injections: Type I diabetes is characterized by the destruction of pancreatic beta cells, resulting in little to no insulin production. Therefore, insulin must be administered via injection to replace the insulin the body cannot produce.

B. The pills are not as effective as the insulin injections: While this might be partially true for Type I diabetes, it is not the complete answer. Oral medications are generally not effective in Type I diabetes because they stimulate the pancreas to produce insulin, which is not possible in these patients.

C. He will only be on insulin injections for a short while, then he can take a pill: This is incorrect. Type I diabetes requires lifelong insulin therapy.

D. He can stop the insulin injections once his body begins to make insulin again: This is incorrect as Type I diabetes is a permanent condition where the body cannot produce insulin.

A. Diminished serum albumin levels cause water to shift from blood to tissue: In cirrhosis, liver dysfunction leads to decreased production of albumin, a protein that helps maintain oncotic pressure. Low albumin levels cause fluid to shift from the vascular space into the tissues, resulting in ascites and peripheral edema.

B. Portal hypotension causes a fluid shift from the abdominal cavity into the portal veins: Portal hypertension, not hypotension, is a common feature of cirrhosis, but it leads to ascites by increasing pressure in the portal venous system, not by shifting fluid into the portal veins.

C. Hypoaldosteronism causes a fluid volume deficit: shifting water from blood into tissue: Cirrhosis often leads to hyperaldosteronism, not hypoaldosteronism, resulting in sodium and water retention, which contributes to edema.

D. Aberrations of the portal system cause a back-up of blood that leads to hydronephrosis: Hydronephrosis is related to obstruction of the urinary tract, not a complication of portal hypertension or cirrhosis.