Nokea
A 23 year old pregnant woman has UTI and presents to the ER with fever, * frequency and urgency. Which of the following antibiotics can cause potential harm to her fetus?
- A. Nitrrfurantoin
- B. Amoxicillin
- C. Gentamycin
- D. Cephalexin
Correct Answer: A
Rationale: The correct answer is A: Nitrofurantoin. Nitrofurantoin is contraindicated in the third trimester of pregnancy due to potential risk of hemolytic anemia in the fetus. It can also cross the placenta and reach the fetal bloodstream. Amoxicillin (B) and Cephalexin (D) are safe for use in pregnancy. Gentamycin (C) is generally not recommended during pregnancy due to potential risk of ototoxicity and nephrotoxicity but is not specifically harmful to the fetus.
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The main reason for the use of combination therapy in the drug treatment of Tuberculosis is:
- A. Reduce the incidence of side effects
- B. Delay or prevent the emergence of resistance
- C. Synergistically increase antimycobacterial activity
- D. Provide prophylaxis against other bacterial infections
Correct Answer: B
Rationale: The main reason for using combination therapy in TB treatment is to delay or prevent the emergence of resistance. Step 1: TB is caused by Mycobacterium tuberculosis, which has a high mutation rate leading to drug resistance. Step 2: With combination therapy, multiple drugs target different aspects of the bacteria's lifecycle, making it harder for resistance to develop. Step 3: This approach ensures that if one drug becomes ineffective due to resistance, others can still be effective. Summary: Choice B is correct as it directly addresses the issue of resistance, which is a critical concern in TB treatment. Choices A, C, and D are incorrect because reducing side effects, increasing antimycobacterial activity, and providing prophylaxis against other bacterial infections are not the primary reasons for using combination therapy in TB.
The nurse is reviewing the changes that occur with menopause. Which changes are associated with menopause?
- A. Uterine and ovarian atrophy, along with a thinning of the vaginal epithelium
- B. Ovarian atrophy, increased vaginal secretions, and increasing clitoral size
- C. Cervical hypertrophy, ovarian atrophy, and increased acidity of vaginal secretions
- D. Vaginal mucosa fragility, increased acidity of vaginal secretions, and uterine hypertrophy
Correct Answer: A
Rationale: Rationale: Answer A is correct because during menopause, there is uterine and ovarian atrophy due to decreased estrogen levels, leading to a thinning of the vaginal epithelium. This is a common physiological change associated with menopause.
Summary of other choices:
B: Incorrect - Increased vaginal secretions and clitoral size do not typically occur with menopause.
C: Incorrect - Cervical hypertrophy and increased acidity of vaginal secretions are not common changes seen with menopause.
D: Incorrect - Vaginal mucosa fragility and uterine hypertrophy are not typical changes associated with menopause.
A 20 year old male patient is diagnosed with Chaga’s disease, American trypanosomiasis. Which drug would be the most appropriate for this patient?
- A. Nifurtimox
- B. Metronidazole
- C. Suramin
- D. Chloroquine
Correct Answer: A
Rationale: The correct answer is A: Nifurtimox. Nifurtimox is the first-line treatment for Chagas disease caused by Trypanosoma cruzi. It is effective in treating both acute and chronic phases of the disease by reducing parasitemia. Metronidazole (B) is used for anaerobic bacterial infections, not trypanosomiasis. Suramin (C) is used for African trypanosomiasis, not American trypanosomiasis. Chloroquine (D) is used for malaria, not trypanosomiasis. Therefore, A is the most appropriate choice for this patient.
Which macrolide antibiotic that can be given once a day for 3 days for empirical treatment of ENT, respiratory and genital infections?
- A. Erythromycin
- B. Azithromycin
- C. Clarithromycin
- D. Roxithromycin
Correct Answer: B
Rationale: The correct answer is B: Azithromycin. It is preferred for short-term treatment due to its long half-life allowing once-daily dosing. Azithromycin has a broad spectrum of activity against many pathogens causing ENT, respiratory, and genital infections. It is well-tolerated and has fewer drug interactions. Other choices like A: Erythromycin have a higher frequency of dosing and more side effects. C: Clarithromycin and D: Roxithromycin are not typically given once daily for 3 days.
In which of the following scenarios is administration of calcium unwise with hyperkalemia?
- A. Rhabdomyolysis.
- B. Nephrotoxic ATN.
- C. Ischaemia ATN.
- D. Acute glomerulonephritis
Correct Answer: D
Rationale: The correct answer is D: Acute glomerulonephritis. In this scenario, administering calcium is unwise with hyperkalemia because acute glomerulonephritis can lead to decreased glomerular filtration rate, which impairs the excretion of potassium. Calcium administration can worsen hyperkalemia by shifting potassium out of cells and into the bloodstream.
Rhabdomyolysis (choice A) can cause hyperkalemia due to cell breakdown, and calcium may be beneficial to stabilize cell membranes. Nephrotoxic ATN (choice B) and ischemic ATN (choice C) are both conditions where calcium administration can help protect kidneys from further damage, but in acute glomerulonephritis, the risk of worsening hyperkalemia outweighs the potential benefits of calcium administration.