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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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A patient is being treated with furosemide and Digoxin because of CHF. She developed UTI. Which of the following antibiotics should NOT be prescribed?
- A. Cotrimoxazole
- B. Ciprofloxacin
- C. Gentamycin
- D. Ampicillin
Correct Answer: C
Rationale: The correct answer is C: Gentamycin. Gentamycin is known to have potential nephrotoxicity, which can exacerbate renal dysfunction caused by furosemide. It should be avoided in patients with CHF and UTI. Cotrimoxazole (A) can be used with caution, Ciprofloxacin (B) is generally safe, and Ampicillin (D) is a suitable choice for UTI treatment in this scenario.
Imipenem has the broadest spectrum of activity currently available to beta-lactams. This include antimicrobial activity against the following organisms EXCEPT:
- A. Staphylococcus aureus
- B. Staphylococcus epidermidis
- C. Pseudomonas aeruginosa
- D. Mycoplasma pneumoniae
Correct Answer: D
Rationale: The correct answer is D: Mycoplasma pneumoniae. Imipenem, a carbapenem antibiotic, has broad-spectrum activity against Gram-positive, Gram-negative, anaerobic, and some atypical bacteria. Mycoplasma pneumoniae is an atypical bacteria lacking a cell wall, making it resistant to beta-lactam antibiotics like imipenem. Staphylococcus aureus, Staphylococcus epidermidis, and Pseudomonas aeruginosa are all susceptible to imipenem due to their cell wall composition.
This drug is a pyrophosphate analog which inhibit DNA polymerase and * reverse transcriptase, is used only to treat associated cytomegalovirus infection in AIDS patient.
- A. Acyclovir
- B. Valacyclovir
- C. Amantadine
- D. Foscarnet
Correct Answer: D
Rationale: The correct answer is D: Foscarnet. Foscarnet is a pyrophosphate analog that inhibits both DNA polymerase and reverse transcriptase, making it effective against cytomegalovirus (CMV) infections in AIDS patients. Acyclovir (A) and Valacyclovir (B) are antiviral drugs used for herpes infections, not CMV. Amantadine (C) is an antiviral used for influenza, not CMV. Therefore, Foscarnet is the correct choice for treating CMV in AIDS patients.
A 32-year-old woman presents with vaginal bleeding and lower abdominal pain. The nurse suspects an ectopic pregnancy. Which of the following is the most common risk factor for ectopic pregnancy?
- A. Previous pelvic surgery.
- B. Endometriosis.
- C. Tubal ligation.
- D. Pelvic inflammatory disease.
Correct Answer: D
Rationale: The correct answer is D: Pelvic inflammatory disease (PID). PID can lead to scarring and narrowing of the fallopian tubes, increasing the risk of ectopic pregnancy. This is because the fertilized egg may get stuck in the narrowed tube, leading to an ectopic pregnancy.
A: Previous pelvic surgery is a risk factor, but it is not the most common one for ectopic pregnancy.
B: Endometriosis can also affect fallopian tubes but is not the most common risk factor for ectopic pregnancy.
C: Tubal ligation is a form of contraception that reduces the risk of pregnancy but does not increase the risk of ectopic pregnancy.
In summary, PID is the most common risk factor for ectopic pregnancy due to its potential to cause fallopian tube scarring and narrowing, leading to the implantation of the fertilized egg outside the uterus.
The nurse is performing a genitourinary assessment on a 50-year-old obese male laborer. On examination, the nurse notices a painless round swelling close to the pubis in the area of the internal inguinal ring that is easily reduced when the individual is supine. These findings are most consistent with a(n) ______ hernia.
- A. Scrotal.
- B. Femoral.
- C. Direct inguinal.
- D. Indirect inguinal.
Correct Answer: C
Rationale: The correct answer is C: Direct inguinal hernia. In this scenario, the key clues are the painless round swelling close to the pubis, easily reduced when supine, and in the area of the internal inguinal ring. Direct inguinal hernias occur due to weakness in the abdominal wall muscles, often seen in older males with increased intra-abdominal pressure. The hernia protrudes directly through the abdominal wall, typically in the area of the internal inguinal ring. Scrotal hernias (Choice A) present in the scrotum, not close to the pubis. Femoral hernias (Choice B) occur below the inguinal ligament and are more common in females. Indirect inguinal hernias (Choice D) pass through the internal inguinal ring and are more common in young males.