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A patient has very high plasma uric acid and has high risk of developing acute uric acid nephropathy. Which of the following agent should be avoided?
- A. Ethacrynic acid
- B. Acetazolamide
- C. Hydrochlorothiazide
- D. Furosemide
Correct Answer: D
Rationale: The correct answer is D: Furosemide. Furosemide is a loop diuretic which can increase uric acid levels in the blood, potentially worsening the patient's condition. Ethacrynic acid (A) is also a loop diuretic and can have similar effects. Acetazolamide (B) is a carbonic anhydrase inhibitor and may increase urinary excretion of uric acid, which can be beneficial in this case. Hydrochlorothiazide (C) is a thiazide diuretic that can actually lower uric acid levels by increasing urinary excretion. Therefore, the best choice to avoid in a patient with high plasma uric acid and risk of acute uric acid nephropathy is furosemide.
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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.
A nurse is preparing a patient diagnosed with benign
- A. When about 80% of the nephrons are no longer prostatic hypertrophy (BPH) for a lower urinary tract functioning cystoscopic examination. The nurse informs the patient that the most common temporary complication
Correct Answer: A
Rationale: Rationale:
1. BPH can cause urinary symptoms.
2. Cystoscopy is a common diagnostic test.
3. Temporary complications include UTI or urinary retention.
4. BPH affects a significant number of nephrons.
5. Choice A aligns with BPH pathophysiology and common complications.
Summary:
- Choice A is correct due to BPH affecting nephrons and causing urinary symptoms leading to temporary complications like UTI. Other choices lack relevance to BPH or its complications.
Which of the following is the most appropriate choice of treating * aspergillosis?
- A. Terbinan
- B. Amphotericin B
- C. Flucytosine
- D. Itraconazole
Correct Answer: B
Rationale: Answer B, Amphotericin B, is the most appropriate choice for treating aspergillosis due to its broad-spectrum antifungal activity, especially against Aspergillus species. It is often used for severe or systemic infections when other options are ineffective. Terbinafine (A) is more commonly used for dermatophyte infections, while Flucytosine (C) is typically used for certain yeast infections. Itraconazole (D) may be effective against some Aspergillus strains but is generally considered less effective than Amphotericin B for severe cases.
Thiazide diuretics may produce an increase in blood levels of uric acid and:
- A. Potassium
- B. BUN
- C. Urea
- D. Glucose
Correct Answer: D
Rationale: Thiazide diuretics can lead to hyperglycemia by reducing insulin sensitivity. This can result in increased blood glucose levels. Thiazides also elevate uric acid levels by reducing its excretion. Therefore, the correct answer is D (Glucose).
Incorrect choices:
A (Potassium) - Thiazides typically cause hypokalemia, not hyperkalemia.
B (BUN) and C (Urea) - Thiazides may cause a slight increase in BUN and serum creatinine levels due to reduced kidney function, but not as significantly as glucose levels.
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.