Nokea
Fred, a newly diagnosed diabetic, is being discharged tomorrow. Which of the following should he be taught to report to his physician?
- A. A weight loss of 2 lb
- B. Having an occasional alcoholic drink
- C. Planning to play in a tennis tournament
- D. An ear infection following swimming
Correct Answer: D
Rationale: An ear infection, especially with diabetes, can increase the risk of complications, and it should be reported immediately.
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When an action potential reaches the axon terminal, what happens next?
- A. The muscle fiber contracts
- B. Acetylcholinesterase breaks down acetylcholine in the synaptic cleft
- C. Endosomes containing neurotransmitter fuse to cell membrane, and release neurotransmitter into the synaptic cleft
- D. Sodium channels open at the motor end plate, moving the cell membrane closer to threshold
Correct Answer: c
Rationale: The correct answer is C because when an action potential reaches the axon terminal, endosomes containing neurotransmitters fuse with the cell membrane and release neurotransmitter into the synaptic cleft. This process is known as exocytosis. This neurotransmitter then binds to receptors on the postsynaptic neuron, initiating a new action potential.
Choice A is incorrect because the muscle fiber contraction is initiated by the binding of the neurotransmitter to receptors on the muscle cell, not directly by the action potential reaching the axon terminal.
Choice B is incorrect because acetylcholinesterase breaks down acetylcholine in the synaptic cleft after it has already been released and has completed its role in transmitting the signal.
Choice D is incorrect because sodium channels opening at the motor end plate is part of the process of muscle cell depolarization and contraction, not directly related to the release of neurotransmitter at the axon terminal.
The ovaries secrete which of the following hormones?
- A. Oestrogen
- B. Luteinising hormone
- C. Follicle stimulating hormone
- D. Oxytocin
Correct Answer: A
Rationale: The correct answer is A: Oestrogen. Ovaries secrete oestrogen, a key female sex hormone involved in the development of secondary sexual characteristics, regulation of the menstrual cycle, and maintenance of pregnancy. Luteinising hormone (B) and follicle stimulating hormone (C) are secreted by the pituitary gland to regulate ovarian function. Oxytocin (D) is produced by the hypothalamus and released by the pituitary gland for uterine contractions and milk ejection, not by the ovaries. Therefore, A is correct as ovaries primarily produce oestrogen.
Which row shows the correct order of reactivity for the elements?
- A. silver, calcium, carbon, potassium
- B. silver, carbon, calcium, potassium
- C. sodium, hydrogen, zinc, gold
- D. sodium, zinc, hydrogen, gold
Correct Answer: D
Rationale: The correct order of reactivity for elements is based on their tendency to lose electrons. In this case, sodium is the most reactive as it readily loses an electron to form a stable ion. Zinc is less reactive compared to sodium but more reactive than hydrogen and gold. Hydrogen is less reactive than both zinc and sodium. Gold is the least reactive among the options given. Therefore, the correct order of reactivity is sodium > zinc > hydrogen > gold, which matches option D. Choices A, B, and C do not follow the correct order of reactivity for the elements listed, making them incorrect.
We have a 48-year-old female patient with a history of myasthenia gravis. She has been treated with an oral acetylcholinesterase inhibitor for several years and has done well till now. She presents with muscle weakness and other signs and symptoms that could reflect either a cholinergic crisis (excess dosages of her maintenance drug) or a myasthenic crisis (insufficient treatment). We will use a rapidly acting parenteral acetylcholinesterase inhibitor (AChE) to help make the differential diagnosis. Which of the following drugs would be most appropriate for this use?
- A. Edrophonium
- B. Malathion
- C. Physostigmine
- D. Pralidoxime
Correct Answer: A
Rationale: The correct answer is A: Edrophonium. Edrophonium is a short-acting acetylcholinesterase inhibitor that can help differentiate between a cholinergic crisis and a myasthenic crisis. In this scenario, administering edrophonium will temporarily increase acetylcholine levels at the neuromuscular junction. If the patient's symptoms improve following edrophonium administration, it suggests a myasthenic crisis due to insufficient treatment. On the other hand, if the symptoms worsen, it indicates a cholinergic crisis due to excess dosages of the maintenance drug.
Choice B: Malathion is an organophosphate insecticide and is not used for diagnosing myasthenia gravis.
Choice C: Physostigmine is a longer-acting acetylcholinesterase inhibitor and is not appropriate for rapidly assessing the patient's condition in this scenario.
Choice D: Pralidoxime is used as an antidote for organophosphate
Target cells for hypothalamic releasing hormones are in the
- A. thyroid
- B. hypothalamus
- C. anterior pituitary
- D. posterior pituitary
Correct Answer: C
Rationale: The correct answer is C: anterior pituitary. Hypothalamic releasing hormones target cells in the anterior pituitary to stimulate the release of specific pituitary hormones. The hypothalamus produces releasing hormones that travel through the hypophyseal portal system and bind to receptors on cells in the anterior pituitary, triggering the release of hormones such as ACTH, TSH, LH, FSH, and GH. This interaction between the hypothalamus and anterior pituitary forms the hypothalamic-pituitary axis, regulating various physiological processes. Choices A (thyroid) and D (posterior pituitary) are incorrect as they are not the primary targets of hypothalamic releasing hormones. Choice B (hypothalamus) is also incorrect as releasing hormones do not target cells within the hypothalamus itself, but rather the anterior pituitary.