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A patient is diagnosed with ischemic heart disease. She is prescribed filgrastim (Neupogen). What effect will this medication provide in the treatment of ischemic heart disease?
- A. Increase platelets
- B. Decrease platelets
- C. Promote angiogenesis
- D. Prevent thrombus formation
Correct Answer: C
Rationale: Filgrastim (Neupogen) is a medication that promotes the growth of white blood cells. In the context of ischemic heart disease, promoting angiogenesis, the formation of new blood vessels, can improve blood flow to the heart muscle, reducing ischemia and potentially improving cardiac function. Therefore, the correct answer is C. Choices A and B are incorrect because filgrastim does not directly affect platelet levels. Choice D is also incorrect as filgrastim does not prevent thrombus formation.
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Which of the following nonpharmacologic treatments is most likely to be a useful and appropriate supplement to pharmacologic analgesia at this point?
- A. Cognitive-behavioral therapy
- B. Cold and heat application
- C. Therapeutic ultrasound
- D. Biofeedback
Correct Answer: B
Rationale: The correct answer is B: Cold and heat application. Cold and heat application are commonly used nonpharmacologic methods for managing pain and can complement pharmacologic treatments. Cold packs can help reduce inflammation and numb localized areas, while heat application can increase blood flow and relax muscles. Cognitive-behavioral therapy (A) focuses on changing negative thought patterns and behaviors to manage pain but may not directly supplement pharmacologic analgesia. Therapeutic ultrasound (C) uses sound waves to generate heat within body tissues, which can be therapeutic, but it may not be as directly complementary to pharmacologic analgesia as cold and heat application. Biofeedback (D) involves using electronic devices to help individuals control physiological processes, but its direct role as a supplement to pharmacologic analgesia may be less pronounced compared to cold and heat application.
A male patient with benign prostatic hyperplasia (BPH) is prescribed finasteride (Proscar). What is the expected therapeutic effect of this medication?
- A. Decreased urinary frequency and urgency
- B. Decreased blood pressure
- C. Increased urinary output
- D. Increased hair growth
Correct Answer: A
Rationale: The correct answer is A: Decreased urinary frequency and urgency. Finasteride is used to reduce the size of the prostate gland in patients with BPH, which helps alleviate symptoms such as urinary frequency and urgency. Choice B, decreased blood pressure, is incorrect because finasteride is not indicated for lowering blood pressure. Choice C, increased urinary output, is incorrect as finasteride does not typically increase urine production. Choice D, increased hair growth, is incorrect as the primary use of finasteride is not for promoting hair growth but rather for treating BPH.
A patient is prescribed sildenafil (Viagra) for erectile dysfunction. What condition would contraindicate the use of this medication?
- A. History of peptic ulcer disease
- B. Use of nitrates
- C. Use of antihypertensive medications
- D. History of hypertension
Correct Answer: B
Rationale: The correct answer is B: Use of nitrates. Sildenafil (Viagra) is contraindicated in patients taking nitrates due to the risk of severe hypotension. Nitrates combined with sildenafil can lead to a dangerous drop in blood pressure. Choices A, C, and D are incorrect because a history of peptic ulcer disease, use of antihypertensive medications, or a history of hypertension are not direct contraindications for sildenafil use.
A woman of childbearing age is diagnosed with breast cancer. She is currently taking hormonal contraceptives. What information should the woman be given regarding the hormonal contraceptives?
- A. The hormonal contraceptives do not affect the course of the disease.
- B. The hormonal contraceptives will stimulate uterine bleeding.
- C. The hormonal contraceptives will impair uterine bleeding.
- D. The hormonal contraceptives will stimulate tumor growth.
Correct Answer: A
Rationale: The correct answer is A. Hormonal contraceptives should be discontinued in women diagnosed with breast cancer because they can potentially stimulate cancer growth. Choice B is incorrect as hormonal contraceptives do not stimulate uterine bleeding. Choice C is also incorrect as hormonal contraceptives typically do not impair uterine bleeding. Choice D is incorrect because hormonal contraceptives are not meant to stimulate tumor growth.
A 30-year-old male has been brought to the emergency department by his wife because of a severe headache, nausea, vomiting, and fever. A lumbar puncture is performed, and cerebrospinal fluid (CSF) analysis reveals a high protein count, low glucose, and numerous polymorphonuclear leukocytes (PMNs). Which organism is the most likely cause of these findings?
- A. Streptococcus pneumoniae
- B. Neisseria meningitidis
- C. Escherichia coli
- D. Listeria monocytogenes
Correct Answer: A
Rationale: The cerebrospinal fluid (CSF) analysis findings of high protein count, low glucose, and numerous polymorphonuclear leukocytes (PMNs) are classic for bacterial meningitis. Among the choices, Streptococcus pneumoniae is the most likely cause in this case. Streptococcus pneumoniae is a common cause of bacterial meningitis in adults, especially presenting with symptoms such as severe headache, nausea, vomiting, and fever. Neisseria meningitidis is another common cause of bacterial meningitis but is more frequently associated with a different CSF profile. Escherichia coli is a common cause of neonatal meningitis, not typically seen in a 30-year-old male. Listeria monocytogenes is more commonly associated with meningitis in immunocompromised individuals and neonates, and typically presents differently in CSF analysis.