Nokea
Obstructive jaundice is:
- A. Caused by more fragile red blood cells.
- B. Associated with high blood hemobilirubin.
- C. Associated with dark stool due to excess stercobilin.
- D. Associated with dark brown urine.
Correct Answer: C
Rationale: Rationale for Correct Answer C: Obstructive jaundice is caused by blockage in the bile ducts, leading to decreased excretion of bilirubin into the intestine. This results in dark stool due to excess stercobilin, a byproduct of bilirubin breakdown. Other choices are incorrect because: A: Fragile red blood cells cause hemolytic jaundice, not obstructive jaundice. B: Elevated blood hemobilirubin is seen in hemolytic jaundice, not obstructive jaundice. D: Dark brown urine is associated with conditions like hemoglobinuria, not obstructive jaundice.
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A 22-yr-old female patient with an exacerbation of ulcerative colitis is having 15 to 20 stools daily and has excoriated perianal skin. Which patient behavior indicates that teaching regarding maintenance of skin integrity has been effective?
- A. The patient uses incontinence briefs to contain loose stools.
- B. The patient uses witch hazel compresses to soothe irritation.
- C. The patient asks for antidiarrheal medication after each stool.
- D. The patient cleans the perianal area with soap after each stool.
Correct Answer: B
Rationale: The correct answer is B: The patient uses witch hazel compresses to soothe irritation. Witch hazel has astringent and anti-inflammatory properties, which can help reduce inflammation and soothe irritated skin. By using witch hazel compresses, the patient is actively taking steps to alleviate discomfort and promote skin healing.
A: The patient using incontinence briefs to contain loose stools does not address the issue of skin integrity maintenance and may lead to prolonged exposure of the skin to stool, exacerbating the problem.
C: Asking for antidiarrheal medication after each stool does not directly address the need for skin integrity maintenance. While it may help reduce stool frequency, it does not specifically target skin healing.
D: Cleaning the perianal area with soap after each stool can be harsh on the already excoriated skin and may further irritate it. Using soap can strip the skin of its natural oils and hinder the healing process.
Although HAV antigens are not tested in the blood, they stimulate specific immunoglobulin M (IgM) and immunoglobulin G (IgG) antibodies. Which antibody indicates there is acute HAV infection?
- A. Anti-HBc IgG
- B. Anti-HBc IgM
- C. Anti-HAV IgG
- D. Anti-HAV IgM
Correct Answer: D
Rationale: The correct answer is D: Anti-HAV IgM. IgM antibodies indicate acute infection as they are the first antibodies produced in response to a new infection. In the case of HAV, the presence of Anti-HAV IgM suggests recent exposure to the virus.
A: Anti-HBc IgG is not relevant to HAV infection. It indicates past or chronic hepatitis B infection.
B: Anti-HBc IgM is specific to hepatitis B infection, not HAV.
C: Anti-HAV IgG indicates past exposure or immunity to HAV, not acute infection.
Which of the following hydrolytic enzymes act in low pH?
- A. Peroxidases
- B. Hydrolases
- C. Amylases
- D. Proteases
Correct Answer: D
Rationale: The correct answer is D: Proteases. Proteases are enzymes that break down proteins, and they are known to function optimally in low pH environments, such as the acidic environment of the stomach. This is because the acidic pH helps in the activation and stability of proteases, allowing them to efficiently break down proteins into smaller peptides and amino acids.
Rationale for why the other choices are incorrect:
A: Peroxidases catalyze oxidation reactions and are not specifically known to act in low pH environments.
B: Hydrolases are a broad category of enzymes that catalyze the hydrolysis of various molecules but are not specifically tailored for low pH conditions.
C: Amylases are enzymes that break down carbohydrates and typically work best in neutral to slightly alkaline pH conditions, not in low pH environments like proteases.
Corticosteroid medications are associated with the development of peptic ulcers because of which probable pathophysiologic mechanism?
- A. The enzyme urease is produced.
- B. Secretion of hydrochloric acid is increased.
- C. The rate of mucous cell renewal is decreased.
- D. The synthesis of mucus and prostaglandins is inhibited.
Correct Answer: D
Rationale: The correct answer is D because corticosteroids inhibit the synthesis of mucus and prostaglandins, which are important for protecting the stomach lining. Without enough mucus and prostaglandins, the stomach lining becomes more susceptible to damage from stomach acid, leading to the development of peptic ulcers.
Choice A is incorrect because the enzyme urease is associated with the development of Helicobacter pylori infection, not peptic ulcers directly. Choice B is incorrect because corticosteroids actually decrease hydrochloric acid secretion. Choice C is incorrect because a decreased rate of mucous cell renewal would lead to decreased mucus production, which could contribute to peptic ulcers, but it is not the primary mechanism associated with corticosteroids.
Saliva decreases gingivitis and caries because it contains immunoglobulin A and
- A. lysozymes.
- B. mucus.
- C. salivary amylase.
- D. water.
Correct Answer: A
Rationale: The correct answer is A: lysozymes. Lysozymes in saliva help to break down bacterial cell walls, reducing the risk of gingivitis and caries. Immunoglobulin A helps to fight off harmful bacteria. Salivary amylase aids in digestion, not in preventing gingivitis or caries. Mucus and water in saliva do not directly contribute to the reduction of gingivitis or caries.