Nokea
A 49-yr-old man who has type 2 diabetes, high blood pressure, hyperlipidemia, and gastroesophageal reflux tells the nurse that he has had recent difficulty in achieving an erection. Which of the following drugs from his current medications list may cause erectile dysfunction (ED)?
- A. Ranitidine (Zantac)
- B. Atorvastatin (Lipitor)
- C. Propranolol (Inderal)
- D. Metformin (Glucophage)
Correct Answer: C
Rationale: The correct answer is C: Propranolol (Inderal). Propranolol is a beta-blocker commonly used to treat high blood pressure, which can lead to erectile dysfunction (ED) as a side effect by affecting blood flow. The other choices, A: Ranitidine (Zantac) is an H2 blocker used for GERD; B: Atorvastatin (Lipitor) is a statin used to lower cholesterol; and D: Metformin (Glucophage) is an oral antidiabetic agent. These medications are not typically associated with causing ED.
You may also like to solve these questions
________ vertebrae are the strongest and largest of the vertebral column.
- A. Lumbar
- B. Sacrum
- C. Thoracic
- D. Cervical
Correct Answer: A
Rationale: The correct answer is A: Lumbar vertebrae. The lumbar vertebrae are the largest and strongest of the vertebral column due to their weight-bearing function in supporting the upper body. They have a larger body and thicker structures compared to other vertebrae, providing stability and support. The sacrum, thoracic, and cervical vertebrae are not as large or strong as the lumbar vertebrae, as they have different functions and shapes tailored to their specific roles in the spine.
What is the cause of menopause?
- A. Reduced levels of gonadotropic hormones secreted from the anterior pituitary gland
- B. Reduced responsiveness of the follicles to the stimulatory effects of gonadotropic hormones
- C. Reduced rate of secretion of progesterone from the corpus luteum
- D. Reduced numbers of follicles available in the ovary for stimulation by gonadotropic hormones
Correct Answer: D
Rationale: The correct answer is D because menopause occurs when the ovaries run out of follicles, which are needed for ovulation and hormone production. This leads to reduced estrogen levels and cessation of menstrual cycles. Choices A and B focus on hormone levels and follicle responsiveness, not the actual follicle count. Choice C is incorrect as progesterone is mainly produced by the corpus luteum after ovulation, not the primary cause of menopause.
Where is the majority of progesterone produced?
- A. Graafian follicle
- B. corpus luteum
- C. secondary follicle
- D. adrenal cortex
Correct Answer: B
Rationale: The correct answer is B: corpus luteum. Progesterone is primarily produced by the corpus luteum, which forms from the ruptured ovarian follicle after ovulation. The corpus luteum secretes progesterone to prepare the uterus for potential implantation of a fertilized egg. The Graafian follicle (choice A) is a mature ovarian follicle that contains the egg, but it does not produce progesterone. The secondary follicle (choice C) is an immature ovarian follicle and does not produce progesterone. The adrenal cortex (choice D) is responsible for producing other hormones like cortisol and aldosterone, not progesterone.
A professional athlete in her mid-20s has not had a menstrual cycle for 5 years, although a bone density scan revealed normal skeletal mineralization. Which of the following facts elicited during the taking of her medical history may explain these observations?
- A. She consumes a high-carbohydrate diet
- B. Her grandmother suffered a hip fracture at age 79
- C. Her blood pressure is greater than normal
- D. Her plasma estrogen concentration is very low
Correct Answer: D
Rationale: The correct answer is D: Her plasma estrogen concentration is very low. The absence of menstrual cycles in a young athlete with normal bone density suggests hypothalamic dysfunction affecting the menstrual cycle. This can result from low estrogen levels, which are essential for the regulation of menstrual cycles. Low estrogen levels can be caused by intense physical activity, leading to suppression of the hypothalamic-pituitary-ovarian axis.
Choice A is incorrect because a high-carbohydrate diet alone is unlikely to cause amenorrhea. Choice B is irrelevant to the absence of menstrual cycles and normal bone density in the athlete. Choice C, elevated blood pressure, is also unrelated to the situation described.
Which of these is not produced by the placenta?
- A. estrogen
- B. relaxin
- C. progesterone
- D. lactogen
Correct Answer: B
Rationale: The correct answer is B: relaxin. The placenta produces estrogen, progesterone, and lactogen to support pregnancy. Relaxin is primarily produced by the corpus luteum and later by the placenta. However, it is not exclusively produced by the placenta, making it the correct choice. Estrogen is crucial for fetal development and maintaining pregnancy. Progesterone helps in preparing the uterus for implantation and supporting the pregnancy. Lactogen (human placental lactogen) plays a role in regulating maternal metabolism and fetal growth.