Genitourinary System Assessment

Genitourinary System Assessment Related

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A 15-year-old boy is seen in the clinic for complaints of “dull pain and pulling” in the scrotal area. On examination, the nurse palpates a soft, irregular mass posterior to and above the testis on the left. This mass collapses when the patient is supine and refills when he is upright. This description is consistent with:

  • A. Epididymitis.
  • B. Spermatocele.
  • C. Testicular torsion.
  • D. Varicocele.
Correct Answer: D

Rationale: The correct answer is D: Varicocele. Varicocele is a dilatation of the pampiniform plexus of veins within the scrotum. In this case, the soft, irregular mass that collapses when the patient is supine and refills when he is upright is characteristic of a varicocele due to the pooling of blood causing the mass to vary in size with position changes.

A: Epididymitis typically presents with redness, warmth, and tenderness in the epididymis, not a soft, irregular mass.
B: Spermatocele is a cystic mass that is typically painless and does not change in size with position changes.
C: Testicular torsion presents with severe, sudden onset of testicular pain, swelling, and discoloration, not a soft, irregular mass that changes with position.

In summary, the description of a soft, irregular mass that changes with position is consistent with a varicocele,

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Combivir is a combination therapy used to treat HIV and AIDS include which * of the following drugs?

  • A. Lamivudine and stavudine
  • B. Lamivudine and zidovudine
  • C. Abacavir and zidovudine
  • D. Abacavir and stavudine
Correct Answer: B

Rationale: The correct answer is B: Lamivudine and zidovudine. Combivir is a combination therapy that consists of these two drugs. Lamivudine and zidovudine work together to inhibit the replication of the HIV virus. Lamivudine is a nucleoside reverse transcriptase inhibitor, while zidovudine is a nucleoside analog reverse transcriptase inhibitor. Both drugs target different stages of the HIV life cycle, making them effective when used in combination.

Choice A (Lamivudine and stavudine) is incorrect because stavudine is not part of the Combivir combination therapy. Choice C (Abacavir and zidovudine) is incorrect because abacavir is not included in Combivir. Choice D (Abacavir and stavudine) is incorrect because stavudine is not part of the Combivir combination therapy.

The following tetracycline has the potential to cause vestibular toxicity:

  • A. Doxycycline
  • B. Oxytetracycline
  • C. Minocycline
  • D. Demeclocycline
Correct Answer: C

Rationale: Step-by-step rationale:
1. Minocycline is known to cause vestibular toxicity due to its lipophilicity and ability to accumulate in inner ear structures.
2. Vestibular toxicity can manifest as dizziness, vertigo, and imbalance.
3. Doxycycline, oxytetracycline, and demeclocycline are less likely to cause vestibular toxicity.
4. Doxycycline is commonly used and well-tolerated, oxytetracycline has a different side effect profile, and demeclocycline is primarily associated with nephrotoxicity.
Summary:
Choice C (Minocycline) is correct due to its propensity for causing vestibular toxicity. Choices A, B, and D are incorrect as they are less likely to cause this specific adverse effect.

A patient has experienced excessive losses of the kidneys

  • A. The left kidneys connection to the common bile duct
  • B. How will this lost bicarbonate be replaced?
Correct Answer: B

Rationale: The correct answer is B because excessive losses of the kidneys can lead to metabolic acidosis due to bicarbonate loss. Bicarbonate is essential for maintaining acid-base balance in the body. Replacement of lost bicarbonate is crucial to prevent acidosis. Choice A is incorrect as the kidneys are not connected to the common bile duct. Choices C and D are not applicable to the scenario provided.

Which of the following interferes with mycolic acid synthesis an essential component of mycobacterial cell walls for which resistance will develop rapidly if the drug is used alone?

  • A. Isoniazid
  • B. Rifampicin
  • C. Pyrazinamide
  • D. Ethanbutol
Correct Answer: A

Rationale: The correct answer is A: Isoniazid. Isoniazid inhibits the synthesis of mycolic acid, a crucial component of mycobacterial cell walls. If used alone, resistance can develop rapidly due to its specific mechanism of action. Rifampicin (B) acts on RNA polymerase, not mycolic acid synthesis. Pyrazinamide (C) targets mycobacteria in acidic environments, not mycolic acid. Ethambutol (D) inhibits arabinosyltransferase, not mycolic acid synthesis.

The examiner is going to inspect and palpate for a hernia. During this exam, the man is instructed to:

  • A. Hold his breath during palpation.
  • B. Cough after the examiner has gently inserted the exam finger into the rectum.
  • C. Bear down when the examiner’s finger is at the inguinal canal.
  • D. Relax in a supine position while the exam finger is inserted into the canal.
Correct Answer: C

Rationale: The correct answer is C: Bear down when the examiner's finger is at the inguinal canal. This action increases intra-abdominal pressure, which helps to push out any potential hernia through the inguinal canal for easier detection. Holding his breath (A) would not facilitate hernia detection. Coughing after insertion (B) is used for rectal exams, not hernia assessment. Relaxing in a supine position (D) is not helpful for hernia examination as it does not aid in hernia protrusion.

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