Nokea
Many people with obesity have a lower insulin-stimulated glucose uptake compared with people without increased body weight. It is assumed that several factors play a role in the development of insulin resistance. Question: Which of the following factors is LEAST likely to play a role in the development of insulin resistance?
- A. Reduced insulin levels
- B. Increased adipokine levels
- C. Increased triglyceride levels
- D. Low-grade continuous inflammation
Correct Answer: A
Rationale: Insulin resistance brews from fat's adipokines, triglycerides, inflammation not low insulin, that's type 1's game. Obesity's chronic jam needs excess, not lack nurses flag this misfit.
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A previously well 25 week pregnant lady presents as a neighbours child she was looking after 2 days ago has developed chicken pox. What would you advise?
- A. Check her serology
- B. Zoster immunoglobulin if negative serology
- C. Prophylactic aciclovir if negative serology
- D. A and B
Correct Answer: A
Rationale: Pregnant, 25 weeks check serology; VZIG or aciclovir jumps if negative, not all. Nurses test first, a chronic fetal guard.
Which does not require post exposure prophylaxis for rabies?
- A. scratch
- B. bite on face
- C. bite on extremity
- D. skin contact with blood, urine or faeces
Correct Answer: D
Rationale: Rabies PEP bites, scratches, bat splashes trigger; blood, pee, poop on skin don't. Nurses skip this chronic non-risk.
How do you treat secondary syphilis?
- A. oral penicillin
- B. i.m. penicillin
- C. i.v. penicillin
- D. erythromycin
Correct Answer: B
Rationale: Secondary syphilis IM penicillin blasts treponemes, not oral, IV, or erythro sidesteps. Nurses shoot this chronic cure.
Which ONE of the following is NOT a diagnostic criterion for Kawasaki's disease?
- A. fever for 5 days
- B. bilateral non purulent conjunctivitis
- C. generalised lymphadenopathy
- D. polymorphous rash
Correct Answer: C
Rationale: Kawasaki fever, eyes, rash, hands fit; lymph's one node, not general. Nurses count this chronic five, not six.
A 35-year old teacher on allopurinol 200 mg OM for the past year reports three recent gout attacks. BMI 27 kg/m2, BP 144/94 mm Hg. You notice tophi over both hands and elbows. You will now:
- A. Stop the allopurinol during this acute gout attack
- B. Start hydrochlorothiazide 25 mg OM for BP control
- C. Continue allopurinol despite the attack and aim to reduce uric acid <300 umol/L
- D. Advise to rest and avoid exercise for 3 months as he is having acute pain
Correct Answer: C
Rationale: Tophi, flares allopurinol stays, push uric <300; thiazides worsen, rest flops, losartan's late. Nurses hold this chronic crystal line.