Nokea
A patient has experienced excessive losses of the kidneys
- A. The left kidneys connection to the common bile duct
- B. How will this lost bicarbonate be replaced?
Correct Answer: B
Rationale: The correct answer is B because excessive losses of the kidneys can lead to metabolic acidosis due to bicarbonate loss. Bicarbonate is essential for maintaining acid-base balance in the body. Replacement of lost bicarbonate is crucial to prevent acidosis. Choice A is incorrect as the kidneys are not connected to the common bile duct. Choices C and D are not applicable to the scenario provided.
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A 20 year old patient presented to the ER with headache, stiff neck and fever for 3 days and is diagnosed with bacterial meningitis. Which one of the following antibiotics is the best choice to treat meningitis?
- A. Cefuroxime
- B. Cephalexin
- C. Cefotaxime
- D. Cefdinir
Correct Answer: C
Rationale: The correct answer is Cefotaxime (C) because it is a third-generation cephalosporin with excellent penetration into the cerebrospinal fluid, making it effective against bacterial meningitis pathogens. Cefotaxime covers a broad spectrum of bacteria commonly causing meningitis, including Streptococcus pneumoniae and Neisseria meningitidis.
A: Cefuroxime (A) is not the best choice as it has limited activity against some of the common pathogens causing meningitis.
B: Cephalexin (B) is a first-generation cephalosporin with poor central nervous system penetration and limited activity against meningitis pathogens.
D: Cefdinir (D) is a third-generation cephalosporin but is not the preferred choice for treating bacterial meningitis due to its inferior CNS penetration compared to cefotaxime.
A 75 year old man is suffering from benign prostatic hypertrophy and is being treated with terazosin. Which of the following adverse reaction would be expected taking this drug?
- A. Erectile dysfunction
- B. Orthostatic hypotension
- C. GI distress
- D. Gynecomastia
Correct Answer: B
Rationale: The correct answer is B: Orthostatic hypotension. Terazosin is an alpha-1 blocker commonly used to treat benign prostatic hypertrophy. It works by relaxing smooth muscle in the prostate and bladder neck. This relaxation can lead to vasodilation and subsequently cause a drop in blood pressure. Orthostatic hypotension is a common adverse reaction of alpha-1 blockers due to this mechanism. The other choices, A: Erectile dysfunction, C: GI distress, and D: Gynecomastia are not typically associated with terazosin use. Erectile dysfunction can actually be improved with alpha-1 blockers as they relax smooth muscle in the prostate, allowing for easier urination and potentially improved sexual function. GI distress and gynecomastia are not common side effects of terazosin.
A 35-year-old woman is at the clinic for a gynecologic examination. During the examination, she asks the nurse, 'How often do I need to have this Pap test done?' Which reply by the nurse is correct?
- A. It depends. Do you smoke?
- B. A Pap test needs to be performed annually until you are 65 years of age.
- C. If you have two consecutive normal Pap tests, then you can wait 5 years between tests.
- D. After age 30 years, if you have three consecutive normal Pap tests, then you may be screened every 2 to 3 years.
Correct Answer: D
Rationale: The correct answer is D because it follows the current guidelines for cervical cancer screening. Starting at age 30, if a woman has had three consecutive normal Pap tests, she can be screened every 2 to 3 years. This is based on the evidence that the risk of cervical cancer is low in women with a history of normal Pap tests. Option A is incorrect as smoking status does not determine Pap test frequency. Option B is incorrect as annual Pap tests are no longer recommended for all women. Option C is incorrect as waiting 5 years between tests is not the standard recommendation based on guidelines.
Antiviral agents that is/ are active against cytomegalovirus (CMV) include * which of the following?
- A. Ganciclovir
- B. Foscarnet
- C. Acyclovir
- D. (
Correct Answer: A
Rationale: Step-by-step rationale for choice A (Ganciclovir) being the correct answer:
1. Ganciclovir is a nucleoside analog that inhibits CMV DNA synthesis.
2. It is specifically approved for the treatment of CMV retinitis in immunocompromised patients.
3. Ganciclovir has a high specificity for CMV, making it an effective antiviral agent against CMV.
Summary of why the other choices are incorrect:
- Choice B (Foscarnet) is also active against CMV but is not as commonly used as Ganciclovir.
- Choice C (Acyclovir) is not effective against CMV as it primarily targets herpes simplex virus and varicella-zoster virus.
- Choice D ( ) is an incomplete choice and does not correspond to any known antiviral agent.
The right atrium myocytes secrete atrial natriuretic peptide (ANP) when there is increased plasma volume. What actions does ANP take to produce a large volume of dilute urine?
- A. Inhibits renin
- B. Increases ADH
- C. Inhibits angiotensin II action
- D. Decreases sodium excretion
Correct Answer: A
Rationale: The correct answer is A: Inhibits renin. ANP inhibits renin release, which leads to decreased aldosterone secretion. This results in decreased reabsorption of sodium and water in the kidneys, promoting excretion of sodium and water, ultimately producing a large volume of dilute urine.
Summary:
B: Increases ADH - ANP actually opposes the action of ADH, which promotes water reabsorption in the kidneys.
C: Inhibits angiotensin II action - ANP does inhibit the action of angiotensin II, but this does not directly lead to the production of dilute urine.
D: Decreases sodium excretion - ANP actually increases sodium excretion by inhibiting renin and aldosterone, leading to decreased reabsorption of sodium.