Nokea
How is plasminogen converted into active plasmin?
- A. By binding to fibrin
- B. By binding to collagen
- C. By binding to heparin
- D. By binding to platelets
Correct Answer: A
Rationale: The correct answer is A: By binding to fibrin. Plasminogen is converted into active plasmin by binding to fibrin through the tissue plasminogen activator (tPA). This binding triggers the activation of plasminogen into plasmin, which then degrades fibrin clots. The other choices (B: collagen, C: heparin, D: platelets) are incorrect because plasminogen activation specifically involves binding to fibrin to initiate the fibrinolytic cascade. Collagen, heparin, and platelets do not play a direct role in the conversion of plasminogen to plasmin.
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Indication for calcium administration is:
- A. Failure of formation of vitamin D in skin
- B. Malabsorption of vitamin D from intestine
- C. Hypercalcemia of malignancy
- D. Vitamin D deficiency
Correct Answer: B
Rationale: Step-by-step rationale:
1. Calcium administration is indicated in malabsorption of vitamin D because vitamin D is necessary for calcium absorption in the intestine.
2. Malabsorption of vitamin D leads to decreased calcium absorption, which can result in calcium deficiency.
3. Administering calcium can help compensate for the decreased absorption of calcium due to vitamin D malabsorption.
Summary:
- Option A is incorrect as the formation of vitamin D in the skin is not directly related to calcium administration.
- Option C is incorrect as hypercalcemia of malignancy indicates excess calcium, not a need for calcium administration.
- Option D is incorrect as it mentions the deficiency of vitamin D, not the malabsorption of vitamin D, which is the indication for calcium administration.
The client has hypertension. Which drug the client is taking has an effect on blood pressure?
- A. Dyazide
- B. Metformin
- C. Digoxin
- D. Warfarin
Correct Answer: A
Rationale: Dyazide (triamterene/HCTZ) is a diuretic that lowers blood pressure by reducing fluid volume.
Regarding verapamil, which one of the following statements is false?
- A. Angina pectoris is an important indication for the use of verapamil
- B. Contraindicated in the asthmatic patient
- C. Relaxes vascular smooth muscle
- D. Slows the depolarization phase of the action potential in AV nodal cells
Correct Answer: B
Rationale: Verapamil is not contraindicated in asthma; it primarily affects cardiac and vascular smooth muscle, not bronchial smooth muscle, unlike beta-blockers.
Furosemide (Lasix) acts at this nephron site:
- A. Proximal convoluted tubule
- B. Ascending thick limb of the loop of Henle
- C. Distal convoluted tubule
- D. Collecting duct
Correct Answer: B
Rationale: The correct answer is B: Ascending thick limb of the loop of Henle. Furosemide inhibits the Na+/K+/2Cl- symporter in this nephron segment, leading to decreased reabsorption of sodium, chloride, and water. This mechanism of action results in increased diuresis. The other choices (A, C, D) represent different nephron segments where Furosemide does not primarily act. In the proximal convoluted tubule (A), it mainly inhibits the Na+/K+/2Cl- symporter, and in the distal convoluted tubule (C) and collecting duct (D), it has minimal impact on sodium reabsorption.
A 74-year-old professional golfer has chest pain that occurs toward the end of his golfing games. He says the pain usually goes away after 1 or 2 sublingual nitroglycerin tablets and rest. What type of angina is he experiencing?
- A. Classic
- B. Variant
- C. Unstable
- D. Prinzmetal’s
Correct Answer: A
Rationale: The correct answer is A: Classic angina. This type of angina is characterized by chest pain occurring predictably with exertion and relieved by rest or nitroglycerin. In this case, the golfer experiences pain at the end of games, consistent with exertional angina. Variant angina (B) occurs at rest due to coronary artery spasm. Unstable angina (C) is characterized by chest pain at rest that is new or changing in pattern. Prinzmetal's angina (D) is also due to coronary artery spasm but typically occurs at rest and is not necessarily related to exertion.