Nokea
A 1mm renal calculi in the ureter will most likely impact at
- A. the pelvi-ureteric junction
- B. the vesico-ureteric junction
- C. the pelvic brim
- D. the bladder orifice
Correct Answer: A
Rationale: The correct answer is A: the pelvi-ureteric junction. A 1mm renal calculi is most likely to impact at this location because the pelvi-ureteric junction is the narrowest part of the ureter, making it more susceptible to blockages. The size of the calculi is small enough to get lodged at this site, causing obstruction and symptoms. The other choices are incorrect because the vesico-ureteric junction and bladder orifice are wider areas, less likely to be obstructed by a small calculi. The pelvic brim is not a common site for renal calculi obstruction.
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Which is incorrect regarding the investigation of UTI?
- A. The sensitivity of dipstick for nitrites is 96%.
- B. A positive dipstick for leucocyte esterase is 96% specific for >10 wbc/mm .
- C. A bacterial culture with > 10 has 95% probability of representing infection.
- D. Use of blood cultures in does not change management when urine culture is taken.
Correct Answer: B
Rationale: The correct answer is B because a positive dipstick for leucocyte esterase is not 96% specific for >10 wbc/mm³. Leucocyte esterase can indicate the presence of white blood cells, but it does not quantitatively correlate with a specific wbc count. Therefore, it cannot be used to accurately determine the exact wbc count in the urine sample.
A: The sensitivity of dipstick for nitrites being 96% means it is good at detecting nitrites, which are a sign of bacterial infection in the urine.
C: A bacterial culture with >10^5 colony-forming units has a high probability of representing infection, typically around 95%.
D: Blood cultures are not routinely used for diagnosing UTIs; urine culture is the primary method. Blood cultures are more often used for systemic infections.
The drug of choice for monilial diarrhea is: *
- A. Amphothericin B
- B. Nystatin
- C. Ketoconazole
- D. Itraconazole
Correct Answer: B
Rationale: The correct answer is B: Nystatin. Nystatin is the drug of choice for monilial diarrhea because it is an antifungal medication specifically effective against Candida species causing the infection in the gastrointestinal tract. It is not absorbed systemically, making it suitable for gastrointestinal infections. Amphothericin B (A) is used for systemic fungal infections. Ketoconazole (C) and Itraconazole (D) are not typically used for gastrointestinal Candida infections.
Which antibiotics should be avoided in patients of liver disease?:
- A. Tetracycline
- B. Cotrimoxazole
- C. Cephalexin
- D. Ethanbutol
Correct Answer: A
Rationale: The correct answer is A: Tetracycline. Tetracycline should be avoided in patients with liver disease due to its potential hepatotoxicity. Tetracycline is primarily metabolized in the liver and can exacerbate liver damage in patients with pre-existing liver conditions. Cotrimoxazole, Cephalexin, and Ethambutol are generally considered safe for use in patients with liver disease as they are not known to cause significant liver toxicity.
To minimize chances of renal calculi recurring, it is important for Mr. Reed to
- A. take prophylactic antibiotics on a daily basis
- B. increase fluid intake
- C. take megadoses of vitamin C daily
- D. get adequate rest to reduce stress and enhance resistance
Correct Answer: B
Rationale: The correct answer is B: increase fluid intake. Adequate hydration helps prevent the formation of kidney stones by diluting the substances in the urine that can lead to stone formation. Increasing fluid intake can also help flush out minerals and toxins from the kidneys.
A: Taking prophylactic antibiotics daily is not recommended for preventing renal calculi as it can lead to antibiotic resistance and potential side effects.
C: Taking megadoses of vitamin C daily can actually increase the risk of kidney stone formation as excess vitamin C can be converted into oxalate, a substance known to contribute to stone formation.
D: While adequate rest and stress reduction are important for overall health, they do not directly prevent the recurrence of renal calculi.
Which of the following drug is a radical curative in plasmodium vivax malaria and is used as prophylaxis for malaria at Chloroquine sensitive regions
- A. Quinine
- B. Primaquine
- C. Mefloquine
- D. Chloroquine
Correct Answer: B
Rationale: The correct answer is B: Primaquine. Primaquine is a radical curative drug for Plasmodium vivax malaria, targeting the liver stage of the parasite to prevent relapse. It is also used as prophylaxis in Chloroquine sensitive regions due to its effectiveness against both the liver and blood stages of the parasite. Quinine (A) is mainly used for treating severe malaria. Mefloquine (C) is used for prophylaxis but not as a radical curative for Plasmodium vivax. Chloroquine (D) is effective against Plasmodium vivax but not as a radical curative.