Nokea
Enlargement of the thyroid gland:
- A. is called a goiter.
- B. causes Addisonian crisis.
- C. makes a person appear cushingoid.
- D. causes hypocalcemic tetany.
Correct Answer: A
Rationale: Step-by-step rationale for why choice A is correct:
1. Enlargement of the thyroid gland is known as a goiter.
2. A goiter can result from various conditions like iodine deficiency or thyroid disorders.
3. It is a common sign of thyroid dysfunction.
4. Goiter may or may not cause symptoms depending on the underlying cause.
5. Therefore, choice A is the correct answer.
Summary:
- Choice B (Addisonian crisis) is incorrect as it is associated with adrenal insufficiency, not thyroid enlargement.
- Choice C (cushingoid appearance) is incorrect as it is related to excess cortisol production, not thyroid enlargement.
- Choice D (hypocalcemic tetany) is incorrect as it is due to low calcium levels, not thyroid enlargement.
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A 43-year-old woman with diagnosed myasthenia gravis presents with profound skeletal muscle weakness. We are unsure whether she is experiencing a cholinergic crisis or a myasthenic crisis, so we administer a usually appropriate dose of parenteral edrophonium. Assume the patient was actually experiencing a cholinergic crisis. Which of the following is the most likely response to the drug?
- A. Hypertensive crisis from peripheral vascular constriction
- B. Myocardial ischemia, and angina, from drug-induced tachycardia and coronary vasoconstriction
- C. Premature ventricular contractions from increased ventricular automaticity
- D. Ventilatory distress or failure
Correct Answer: D
Rationale: The correct answer is D: Ventilatory distress or failure. Edrophonium is a short-acting acetylcholinesterase inhibitor used to differentiate between myasthenic and cholinergic crises. In a cholinergic crisis, which is an excess of acetylcholine, administering edrophonium can worsen symptoms due to further acetylcholine accumulation. This can lead to excessive stimulation of the respiratory muscles, resulting in ventilatory distress or failure.
Choice A is incorrect because cholinergic crisis typically causes hypotension, not hypertension. Choice B is incorrect because edrophonium-induced tachycardia can worsen myocardial ischemia, not angina. Choice C is incorrect because increased ventricular automaticity would not be a common response to edrophonium in a cholinergic crisis.
The endocrine gland(s) that makes insulin is the:
- A. pancreas
- B. adrenal glands
- C. thyroid gland
- D. pituitary gland
Correct Answer: A
Rationale: The correct answer is A: pancreas. The pancreas is responsible for producing insulin, a hormone that helps regulate blood sugar levels. It is located near the stomach and plays a crucial role in the endocrine system. The other choices (B: adrenal glands, C: thyroid gland, D: pituitary gland) do not produce insulin. Adrenal glands produce hormones like adrenaline and cortisol, thyroid gland produces hormones like thyroxine, and the pituitary gland produces various hormones that regulate other endocrine glands. Therefore, the pancreas is the only gland among the options that produces insulin, making it the correct answer.
Pilocarpine is used in the treatment of:
- A. Heart failure
- B. Bronchial asthma
- C. Urinary obstruction
- D. Glaucoma
Correct Answer: D
Rationale: Pilocarpine is a parasympathomimetic agent that stimulates the muscarinic receptors in the eye, causing pupillary constriction and reducing intraocular pressure. This mechanism of action makes it effective in treating glaucoma. Heart failure (A), bronchial asthma (B), and urinary obstruction (C) are not indications for pilocarpine use based on its pharmacological properties and effects.
Which statement about the reaction is correct?
- A. It is endothermic and thermal energy is absorbed from the surroundings.
- B. It is endothermic and thermal energy is transferred to the surroundings.
- C. It is exothermic and thermal energy is absorbed from the surroundings.
- D. It is exothermic and thermal energy is transferred to the surroundings.
Correct Answer: A
Rationale: The correct answer is A because an endothermic reaction absorbs thermal energy from the surroundings to proceed. In an endothermic reaction, the products have higher potential energy than the reactants, requiring energy input. Choice B is incorrect as endothermic reactions do not transfer thermal energy to the surroundings. Choices C and D are incorrect as they describe exothermic reactions, where thermal energy is released to the surroundings.
A patient with Alzheimer's disease is taking an acetylcholinesterase inhibitor specifically approved for that indication, primarily because it is quite lipophilic and so enters the CNS well. Which of the following drugs is the patient most likely receiving?
- A. Donepezil
- B. Edrophonium
- C. Neostigmine
- D. Pyridostigmine
Correct Answer: A
Rationale: The correct answer is A: Donepezil. Donepezil is a lipophilic acetylcholinesterase inhibitor approved for Alzheimer's disease due to its ability to enter the CNS effectively. It enhances cholinergic transmission by inhibiting the enzyme responsible for acetylcholine breakdown. Edrophonium is a short-acting acetylcholinesterase inhibitor used for diagnostic purposes, not for Alzheimer's treatment. Neostigmine and Pyridostigmine are not lipophilic and are primarily used for myasthenia gravis to enhance muscle strength, not for Alzheimer's disease.