Nokea
A pregnant patient is admitted to the hematology department with moderately severe hemolytic anemia. After thorough workup, the only positive finding is a history of treatment with an antihypertensive drug since 2 months. The most likely cause is:
- A. Atenolo
- B. Captopril
- C. Hydralazine
- D. Methyldopa
Correct Answer: D
Rationale: Methyldopa is associated with hemolytic anemia via a positive Coombs' test.
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Indicate the neuromuscular blocker, whose breakdown product readily crosses the blood-brain barrier and may cause seizures:
- A. Pancuronium
- B. Succinylcholine
- C. Tubocurarine
- D. Atracurium
Correct Answer: D
Rationale: The correct answer is D: Atracurium. Atracurium is metabolized to laudanosine, which readily crosses the blood-brain barrier and may cause seizures. Pancuronium (A) does not readily cross the blood-brain barrier. Succinylcholine (B) does not have a breakdown product that crosses the blood-brain barrier. Tubocurarine (C) does not produce a breakdown product that causes seizures.
Which of the following statements concerning vitamin C functions are true:
- A. Active functional form is pyridoxal phosphate, which is an essential coenzyme for transamination and decarboxylation of amino acids in more than 50 different enzyme systems
- B. Essential constituent of coenzyme A, the important coenzyme for acyl transfer in the TCA cycle and de novo fatty acid synthesis
- C. Carrier of one-carbon (e.g. methyl) groups that are added to, or removed from, metabolites such as histidine, serine, methionine, and purines
- D. Has antioxidant properties and is required for various hydroxylation reactions e.g. proline to hydroxypoline for collagen synthesis
Correct Answer: D
Rationale: Rationale:
1. Vitamin C is known for its antioxidant properties, which help in neutralizing free radicals and protecting cells from damage.
2. It is required for hydroxylation reactions, such as converting proline to hydroxyproline for collagen synthesis, essential for maintaining connective tissues.
3. Vitamin C does not function as pyridoxal phosphate (choice A) or a constituent of coenzyme A (choice B).
4. While vitamin C is involved in one-carbon metabolism, it does not directly act as a carrier of one-carbon groups as described in choice C.
Summary:
The correct answer (D) highlights the antioxidant properties and the role of vitamin C in hydroxylation reactions for collagen synthesis. Choices A, B, and C are incorrect as they misrepresent the functions of vitamin C.
Which of the following oral hypoglycaemic drugs stimulates both synthesis and release of insulin from beta islet cells:
- A. Glibenclamide
- B. Phenformin
- C. Buformine
- D. Metformin
Correct Answer: A
Rationale: Rationale: Glibenclamide is a sulfonylurea drug that acts by closing ATP-sensitive potassium channels in beta islet cells, leading to calcium influx and insulin release. It stimulates both insulin synthesis and release. Phenformin, Buformine, and Metformin do not directly stimulate insulin release, making them incorrect choices.
Which statement represents the most appropriate instructions for a patient with a past suicide attempt who is prescribed amitriptyline (Elavil), 150 mg PO at bedtime?
- A. “You will need to pick up your 7-day supply of medication at the pharmacy each week.”
- B. “Your prescription will provide you with a 6-month supply to save you money and time.”
- C. “I’m going to strongly suggest that your spouse dispense this medication to you each evening.”
- D. “Stop by the clinic each evening for your medication so your emotional state of mind can be assessed.”
Correct Answer: A
Rationale: The correct answer is A because picking up a 7-day supply at the pharmacy each week ensures regular monitoring and compliance. This allows healthcare professionals to assess the patient's response to the medication and monitor for any potential side effects or worsening of symptoms. The other choices are incorrect because B does not address the need for regular monitoring, C may not be feasible for all patients and may compromise patient autonomy, and D is impractical and does not provide consistent access to medication.
Hormone analogues are:
- A. Naturally occurring substances but slightly different from hormones
- B. Naturally occurring substances but less efficacious than hormones
- C. Naturally occurring substances having the same structure but different pharmacological properties than hormones
- D. Synthetic compounds which resemble the naturally occurring hormones
Correct Answer: D
Rationale: The correct answer is D because hormone analogues are synthetic compounds that mimic the structure and function of naturally occurring hormones. This is important for therapeutic purposes as they can be used to replace or mimic the actions of hormones in the body.
A is incorrect because hormone analogues are not naturally occurring substances but rather synthetic compounds. B is incorrect as hormone analogues can be equally or even more efficacious than naturally occurring hormones. C is incorrect because although hormone analogues may have similar structures to hormones, they do not necessarily have the same pharmacological properties.