Nokea
In which type of dialysis does the patient dialyze during sleep and leave the fluid in the abdomen during the day?
- A. Long nocturnal hemodialysis
- B. Automated peritoneal dialysis (APD)
- C. Continuous venovenous hemofiltration (CVVH)
- D. Continuous ambulatory peritoneal dialysis (CAPD)
Correct Answer: B
Rationale: The correct answer is B: Automated peritoneal dialysis (APD). In APD, the patient connects to a machine at night for dialysis while sleeping, and during the day, the dialysis fluid remains in the abdomen. This allows for continuous treatment without the need for daytime exchanges.
A: Long nocturnal hemodialysis involves nighttime hemodialysis sessions but does not involve leaving fluid in the abdomen during the day.
C: Continuous venovenous hemofiltration is a continuous renal replacement therapy used in critically ill patients, not for ambulatory dialysis.
D: Continuous ambulatory peritoneal dialysis (CAPD) requires manual exchanges throughout the day, unlike APD where the fluid remains in the abdomen during the day.
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Which of the following drugs valuable in the treatment of edema and metabolic alkalosis?
- A. Digoxin
- B. Spironolactone
- C. Dobutamine
- D. Acetazolamide
Correct Answer: D
Rationale: The correct answer is D: Acetazolamide. Acetazolamide is a carbonic anhydrase inhibitor that helps in the treatment of edema and metabolic alkalosis by promoting diuresis and increasing renal excretion of bicarbonate. It is effective in treating conditions associated with fluid retention and alkalosis.
A: Digoxin is a cardiac glycoside used to treat heart conditions like heart failure and atrial fibrillation, not edema or metabolic alkalosis.
B: Spironolactone is a potassium-sparing diuretic commonly used for conditions like hypertension and heart failure, but not specifically for metabolic alkalosis.
C: Dobutamine is a beta-adrenergic agonist used in acute heart failure or shock situations, not for edema or alkalosis.
In summary, Acetazolamide is the correct choice as it directly targets edema and metabolic alkalosis by affecting renal excretion of bicarbonate. Other options are
The drug of choice for monilial diarrhea is:
- A. Amphothericin B
- B. Nystatin
- C. Ketoconazole
- D. Itraconazole
Correct Answer: B
Rationale: Step-by-step rationale for why Nystatin is the correct choice for monilial diarrhea:
1. Nystatin is an antifungal medication specifically effective against Candida species causing monilial infections.
2. It works by binding to ergosterol in fungal cell membranes, disrupting membrane integrity and causing cell death.
3. Nystatin is not absorbed systemically, making it suitable for gastrointestinal infections.
4. Amphothericin B is reserved for severe systemic fungal infections due to its significant toxicity. Ketoconazole and Itraconazole are not typically used for gastrointestinal Candida infections, as they are more commonly used for systemic fungal infections.
During the examination of a full-term newborn male, a finding requiring investigation would be:
- A. Absent testes
- B. Meatus centered at the tip of the penis
- C. Wrinkled scrotum
- D. Penis 2 to 3 cm in length
Correct Answer: A
Rationale: The correct answer is A: Absent testes. In a full-term newborn male, the absence of testes is a concerning finding that requires immediate investigation to rule out conditions like undescended testes or any underlying genetic abnormalities. This is crucial for ensuring normal development and future fertility.
The other choices are incorrect because:
B: Meatus centered at the tip of the penis is a normal finding in a full-term newborn.
C: Wrinkled scrotum is a common and normal variation in newborns and does not typically require immediate investigation.
D: Penis 2 to 3 cm in length is within the expected range for a full-term newborn and is not a cause for concern.
Which statement concerning the testes is true?
- A. The lymphatic vessels of the testes drain into the abdominal lymph nodes.
- B. The vas deferens is located along the inferior portion of each testis.
- C. The right testis is lower than the left because the right spermatic cord is longer.
- D. The cremaster muscle contracts in response to cold and draws the testicles closer to the body.
Correct Answer: D
Rationale: The correct answer is D: The cremaster muscle contracts in response to cold and draws the testicles closer to the body. This is true because the cremaster muscle is responsible for regulating the position of the testicles in response to temperature changes to maintain optimal conditions for sperm production. The other choices are incorrect because: A: The lymphatic vessels of the testes drain into the para-aortic lymph nodes, not the abdominal lymph nodes. B: The vas deferens is a duct that carries sperm from the testes to the urethra, not located along the inferior portion of each testis. C: The difference in height between the testes is due to differences in the descent of the testes during fetal development, not the length of the spermatic cord.
In the presence of antidiuretic hormone (ADH), or vasopressin, water is mostly reabsorbed in the ___________ of the nephron.
- A. Proximal convoluted tubule
- B. Loop of henle
- C. Collecting duct
- D. Distal convoluted tubule
Correct Answer: A
Rationale: The correct answer is A: Proximal convoluted tubule. ADH acts on the collecting duct and distal convoluted tubule to increase water reabsorption. However, the majority of water reabsorption occurs in the proximal convoluted tubule due to its high permeability to water. This segment reabsorbs about 65% of filtered water, mainly through osmosis. The loop of Henle plays a crucial role in concentrating urine, but it is not the main site of water reabsorption. The collecting duct responds to ADH but reabsorbs a smaller fraction of filtered water compared to the proximal tubule. The distal convoluted tubule is primarily involved in electrolyte reabsorption rather than water reabsorption.