Nokea
Patients with nephrolithiasis or kidney stones need to increase fluid intake. This is to:
- A. Concentrate the urine.
- B. Help flush the stones through the urinary tract.
- C. Crystallize the struvite from the renal tubules.
- D. Break down the stones into smaller pieces that will more easily pass through the urinary tract.
Correct Answer: B
Rationale: The correct answer is B: Help flush the stones through the urinary tract. Increasing fluid intake can help dilute the urine, preventing stone formation and aiding in the passage of existing stones. Adequate hydration promotes frequent urination, which can help flush out the stones and reduce the risk of complications. Choices A, C, and D are incorrect. A: Concentrating the urine can actually exacerbate stone formation. C: Struvite crystals are not typically formed in nephrolithiasis. D: Breaking down stones requires medical intervention, not just increased fluid intake.
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Isoniazid is a primary antitubercular agent that:
- A. Requires pyridoxine (Vit B6) supplementation
- B. Penetrates the BBB and enters the brain useful in TB meningitis
- C. Causes ocular complications that are reversible if the drug is discontinued
- D. May be ototoxic and nephrotoxic
Correct Answer: A
Rationale: Step-by-step rationale for choice A being correct:
1. Isoniazid can lead to pyridoxine deficiency.
2. Pyridoxine supplementation helps prevent neurotoxicity.
3. Thus, isoniazid therapy requires pyridoxine supplementation.
Summary of why other choices are incorrect:
B: Isoniazid does not effectively penetrate the BBB.
C: Ocular complications of isoniazid are generally irreversible.
D: Ototoxicity and nephrotoxicity are not common side effects of isoniazid.
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.
The penicillin G preparation with the longest duration of action is: *
- A. Benzathine penicillin
- B. Sodium penicillin
- C. Potassium penicillin
- D. Procaine penicillin
Correct Answer: D
Rationale: The correct answer is D: Procaine penicillin. Procaine penicillin is a long-acting penicillin formulation due to the addition of procaine, which slows down the release of penicillin into the bloodstream. This results in a prolonged duration of action compared to benzathine, sodium, and potassium penicillin. Benzathine penicillin is also long-acting but primarily used for prevention, not treatment. Sodium and potassium penicillin are not formulated for extended action, making them less suitable for long-term treatment. Therefore, D is the best choice for long-lasting penicillin therapy.
A 50-year-old woman reports that she has been experiencing hot flashes, night sweats, and vaginal dryness. The nurse suspects that she is in the peri-menopausal stage. What is the primary reason for these symptoms?
- A. Decreased estrogen levels.
- B. Increased estrogen levels.
- C. Hormonal fluctuations.
- D. Psychological stress.
Correct Answer: D
Rationale: I must clarify that the correct answer should be A: Decreased estrogen levels. In the peri-menopausal stage, a woman's ovaries produce less estrogen, leading to symptoms like hot flashes, night sweats, and vaginal dryness. Option B is incorrect because increased estrogen levels are not typical during peri-menopause. Option C is vague and does not specifically address the primary reason for the symptoms. Option D, psychological stress, may exacerbate symptoms but is not the primary cause in this scenario.
Which of the following drugs for treatment of leprosy can cause hemolysis * especially in patients with G6PD deficiency?
- A. Dapsone
- B. Rifampicin
- C. Clofazimine
- D. None of these
Correct Answer: A
Rationale: Rationale:
1. Dapsone is a known cause of hemolysis in patients with G6PD deficiency due to oxidative stress.
2. Dapsone triggers the release of reactive oxygen species, leading to hemolysis in G6PD-deficient individuals.
3. Rifampicin and clofazimine do not have a direct association with hemolysis in G6PD deficiency.
4. Option D is incorrect as dapsone is a well-established drug associated with hemolysis in G6PD-deficient individuals.