Nokea
A 55 year old man with kidney stones has been placed on a diuretic to decrease calcium excretion. However after a few weeks, he develops an attack of gout. Which diuretic is he taking?
- A. Furosemide
- B. Spironolactone
- C. Hydrochlorothiazide
- D. Triamterene
Correct Answer: C
Rationale: The correct answer is C: Hydrochlorothiazide. Hydrochlorothiazide is a thiazide diuretic that works by reducing calcium excretion and increasing uric acid levels, which can lead to gout attacks in susceptible individuals. Furosemide (choice A) is a loop diuretic that does not increase uric acid levels. Spironolactone (choice B) is a potassium-sparing diuretic and does not affect calcium or uric acid levels significantly. Triamterene (choice D) is also a potassium-sparing diuretic and does not impact calcium or uric acid levels in the same way as hydrochlorothiazide.
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Cloxacillin is indicated in infections caused by the following organism(s) * a Staphylococci
- A. Streptococci
- B. Gonococci
- C. All of the above
Correct Answer: A
Rationale: Step-by-step rationale:
1. Cloxacillin is a beta-lactam antibiotic effective against Staphylococci.
2. Streptococci are not within the spectrum of activity for Cloxacillin.
3. Gonococci are also not susceptible to Cloxacillin.
4. Therefore, the correct answer is A (Streptococci), as Cloxacillin is indicated only for Staphylococcal infections.
Summary:
Choice A is correct because Cloxacillin is effective against Staphylococci. Choices B and C are incorrect because Cloxacillin is not indicated for Gonococci or all of the organisms mentioned.
Which of the following drug/(s) that is /are used to treat chronic hepatitis B? *
- A. Lamivudine
- B. Human interferon α
- C. Amantadine
- D. (
Correct Answer: A
Rationale: Step-by-step rationale for why A (Lamivudine) is correct:
1. Lamivudine is a nucleoside analog reverse transcriptase inhibitor used to treat chronic hepatitis B.
2. It inhibits the replication of the hepatitis B virus, reducing viral load and liver damage.
3. Clinical studies have shown its efficacy in improving liver function and reducing the risk of cirrhosis.
4. Lamivudine is recommended as a first-line treatment option by major medical guidelines.
Summary of why other choices are incorrect:
B. Human interferon α: While interferon therapy was previously used, it is no longer recommended as a first-line treatment due to its side effects and lower efficacy compared to newer drugs.
C. Amantadine: Amantadine is not recommended for the treatment of chronic hepatitis B as it is not effective against the hepatitis B virus.
D. (: This is not a valid drug option for treating chronic hepatitis B.
Which of the following drug adverse reactions precludes a patient from being * given the same drug in the future?
- A. GI upset from Clarithromycin
- B. Skin Rash from Ampicillin
- C. Steven-Johnson syndrome from Trimetoprim/Sulfamethoxazole
- D. Clostridium decile superinfection from Ooxacin
Correct Answer: C
Rationale: The correct answer is C: Steven-Johnson syndrome from Trimethoprim/Sulfamethoxazole. Steven-Johnson syndrome is a severe and potentially life-threatening adverse reaction characterized by rash, blistering, and mucosal involvement. Once a patient experiences Steven-Johnson syndrome from a specific drug like Trimethoprim/Sulfamethoxazole, they should never be given that drug again due to the high risk of recurrence and the severity of the reaction. This is known as a contraindication, making it unsafe to administer the drug in the future.
A, B, and D are incorrect because GI upset from Clarithromycin, skin rash from Ampicillin, and Clostridium difficile superinfection from Ciprofloxacin, while unpleasant, are not typically considered contraindications for future use of the same drug. These adverse reactions can often be managed with dose adjustments, alternative medications, or supportive care without ruling out the drug entirely
Which of the following antibiotics is considered safe to use in newborn * babies?
- A. Chloramphenicol
- B. Trimethoprim/Sulfamethoxazole
- C. Teracyclines
- D. Ampicillin
Correct Answer: D
Rationale: The correct answer is D: Ampicillin. Ampicillin is considered safe for use in newborn babies because it is a commonly used antibiotic in neonates and has a favorable safety profile. It is effective against a wide range of bacteria commonly found in newborns. Chloramphenicol (A) can cause serious side effects like gray baby syndrome. Trimethoprim/Sulfamethoxazole (B) is not recommended in newborns due to potential risks. Tetracyclines (C) can lead to tooth discoloration and bone growth inhibition in newborns.
A 30-year-old woman presents to the clinic with a complaint of a delayed period and abdominal discomfort. The nurse suspects pregnancy. Which of the following is the earliest and most reliable sign of pregnancy?
- A. A missed period.
- B. Positive urine pregnancy test.
- C. Changes in breast size.
- D. Abdominal tenderness and bloating.
Correct Answer: C
Rationale: The correct answer is C: Changes in breast size. This is because hormonal changes in early pregnancy can cause breast tenderness, swelling, and darkening of the areola. This typically occurs before a missed period or a positive urine pregnancy test. A missed period (choice A) is a common sign of pregnancy, but not the earliest. A positive urine pregnancy test (choice B) confirms pregnancy but may not be the earliest sign. Abdominal tenderness and bloating (choice D) can occur due to various reasons and are not specific to pregnancy. Therefore, changes in breast size are the earliest and most reliable sign of pregnancy in this scenario.